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Background: Epidemiological data on the incidence of surgical treatment of pediatric fractures are sparse. Our aim was to determine the incidence of in-hospital-treated fractures and of the surgical treatment of these fractures in children and adolescents.Methods: National Discharge Register data on pediatric fractures (in patients younger than the age of eighteen years) treated in the hospital in Finland between 1997 and 2006 were evaluated.Results: During the ten-year follow-up period, the incidence (per 100,000 persons) of fractures leading to hospitalization increased by 13.5% (from 319 in 1997 to 362 in 2006; p < 0.001). This change resulted mainly from an increase in the incidence of hospital-treated upper-extremity fractures (23% increase; from 189 in 1997 to 232 in 2006). The incidence of primary fracture surgery increased by 20% (from 237 in 1997 to 284 in 2006; p < 0.001). The incidences of surgery for upper-extremity, lower-extremity, and axial fractures increased by 28%, 3.9%, and 10.7%, respectively. Within the upper-extremity-fracture group, the incremental increase was mainly due to an increase in forearm fracture surgery (62% increase; from fifty-five in 1997 to eighty-nine in 2006) (p < 0.001).Conclusions: Operative treatment of children's fractures has increased markedly during the last ten years. Evidence-based medical and economic data supporting this change in practice are sparse.