Inclusion Criteria:  Presented for an in-office procedure after a primary orthopedic injury Willing to participate in the study. Between age of 5 and 18  Exclusion Criteria:  Any condition limiting subject ability to perceive and communicate information including developmental delay, Cerebral Palsy, or Autism Spectrum Disorder. Limitations in subject ability to use the VR system including an inability to sit upright or bilateral upper extremity injuries