Accidents are the leading cause of childhood mortality and rank second only to acute infections as the cause of morbidity. The hospital morbidity and long term sequelae of injuries in children have greater medical and social significance than in adults. In order to determine what role the skeletal injuries play in morbidity and residual impairment in the severely injured children, We studied 75 consecutive surviving children who had multiple injuries, including a major fracture of at least one extremity or of the pelvic girdle. The severity of injuries was classified according to the Modified Injury Severity Scale (MISS) and compared severity of injuries with residual impariment. The results were obtained as follows. 1. Of 75 injured children, boys were 47 and 33 of the children were 6 to 10 years old. 2. Cause of injury of 66 children was motor-Vehicle related accident. 3. Most frequently combined injury with muosulosgkeletal injury was neural injury. 4. There were 133 fractures in 75 children and femoral fracture was most frequent. 5. The mean score on the MISS of 75 children was 21. Fifty-three ehildren had a score of 25 points or less. 6. Twenty-eight children had residual impairment, and their mean on the MISS was 25. 7. Most of the musculoskeletal impairment were attributable to the nature of initial injury.