Objective To investigate the application efficacy of Cloud-Empowered Family Decision-making Support in the Accelerated Rehabilitation Course of Children with Congenital Pseudarthrosis of the Tibia Undergoing Combined Surgical Procedures. Methods A total of 32 children admitted from January 2022 to December 2022 were assigned to the control group, receiving health guidance based on the concept of enhanced recovery after surgery (ERAS) . Another 32 children admitted from January 2023 to December 2023 were set as the observation group, adopting the "cloud-enabled family decision-making assistance" program on the basis of the control group's intervention. The postoperative recovery, compliance with functional exercise, mastery of health knowledge, attitude and degree of family participation in treatment decision-making, as well as satisfaction, were compared between the two groups. Results There was no significant difference in exercise fear levels between the two groups on the admission day. One week after surgery, the exercise fear level in the observation group (35.63±3.15) was lower than that in the control group (41.91±2.92) . The first defecation time in the observation group (1.1±0.12 days) was shorter than that in the control group (3.5±0.89 days) , and the incidence of pin tract infection (3.1%) was lower than that in the control group (12.5%) . The compliance scores of functional exercise in the observation group were higher than those in the control group at the first week (59.09±3.31 vs. 55.75±2.72) and the first month (64.59±3.11 vs. 57.59±3.34) after surgery. Both the scores of health theoretical knowledge (90.32±6.3) and operational skills (92.12±3.23) in the observation group were higher than those in the control group. The scores of family attitude and degree of participation in treatment decision-making in the observation group were lower than those in the control group, indicating a higher actual participation in treatment decision-making. There was no significant difference in the information dimension of family decision-making participation satisfaction between the two groups, but the total score of decision-making participation satisfaction in the observation group was significantly higher than that in the control group. Conclusion The application of Cloud-Empowered Family Decision-making Assistance in the accelerated rehabilitation of children with congenital tibial pseudarthrosis undergoing combined surgeries can achieve a shorter gastrointestinal recovery time and a lower level of fear of movement, improve the mastery of health knowledge, strengthen the compliance of functional exercises, enhance the attitude, degree and satisfaction of family participation in treatment decision-making, and promote an earlier recovery.