There have been many changes in children's orthopaedics and considerable developments in fracture management, markedly improved use of external fixators and the scientific development of, for example, the Taylor spatial frame to correct complex deformities. The use of ultrasound has increased considerably in the diagnosis of children's disorders and there are more sophisticated ways of analysing deformities. There are also new classifications for unstable slipped epiphysis and our genetic understanding of children's disorders has increased exponentially.