Forty-eight children's hospitals were studied and compared in order to analyze factors influencing changes in these institutions and to delineate their needs for the future. Alterations in disease patterns, the interrelationship of hospitals, agencies, and medical specialties as they have bearing upon patient care, resident-training, and research have been considered. Charts and tables have been presented to illustrate trends, and opinions have been gathered as to the general needs of orthopaedics. A broadening concept of children's orthopaedics is proposed.