Objective:To evaluate the ultrasonography-guided percutaneous leverage reduction in the treatment of pediatric radial neck fractures.Methods:From May 2016 to May 2018, 42 patients with Judet Ⅲ or Ⅳ radial neck fracture were treated at Department of Pediatric Orthopedics, The Second Hospital of Fuzhou. They were 15 boys and 27 girls, aged from 3 to 12 years. All of them were treated by percutaneous leverage reduction and Métaizeau technique. The operative procedures were guided by ultrasonography in 20 cases and by C-arm fluoroscopy in 22 cases. Postoperative evaluation was based on Métaizeau imaging criteria, Tibone and Stoltz functional criteria; complications such as radial nerve injury were recorded.Results:There were no statistically significant differences between the ultrasonography-guided group and the fluoroscopy-guided group in preoperative general data, showing comparability ( P>0.05). There were no significant differences between the 2 groups in terms of Métaizeau imaging, Tibone or Stoltz functional scores ( P>0.05). The frequency of fluoroscopy was (2.7±0.6) times for the ultrasonography group and (14.6±3.4) times for the fluoroscopy group while the operation time averaged (25.8±5.9) min for the former and (38.1±9.2) min for the latter, showing significant differences ( P<0.05). No postoperative complications were observed in the ultrasonography group while 4 cases of radial nerve injury in the fluoroscopy group, also showing significant difference between the 2 groups ( P< 0.05). Conclusion:Ultrasonography-guided percutaneous leverage reduction is a suitable surgical treatment of radial neck fracture in children, because it is simple, effective and safe.