The study evaluated the effect of the Child Life intervention combined with a comprehensive nutritional intervention on pain management, nutritional status and treatment adherence in 100 school-age children with limb fractures treated in hospital from March to September 2024. The children were randomly divided into a control group (CG, 50 cases) with a conventional nursing intervention and an observation group (OG, 50 cases) with the added Child Life intervention and nutritional support. At 12 and 24 hours after surgery, FLACC pain scores were lower in OG than in CG (p < 0.001, t = 5.042; p < 0.041, t = 36). Serum cortisol level decreased significantly more in OG than in CG (p < 0.001, t = 6.049 and t = 11.662). Treatment compliance in OG was higher than in CG (p = 0.037, χ² = 4.332; p = 0.017, χ² = 5.741; p = 0.025, χ² = 5.005). At 24 hours after surgery, levels of lymphocytes (Lc), hemoglobin (HGB), prealbumin (PA), and albumin (ALB) were higher in OG than in CG (p < 0.01, t = 2.717; p < 0.001, t = 3.433 and t = 5.023). The intervention improved pain management, reduced stress, nutritional status and accelerated recovery.