One hundred eighty-eight patients with orthopaedic conditions were randomized to receive either immersive virtual reality (VR) (n=94) or a non-immersive video game on a tablet (n=94). Outcomes of interest included pain (Numerical Rating Scale; NRS), anxiety (Child Fear Scale; CFS), satisfaction of parents and children, and satisfaction of caregivers. Outcomes were assessed at baseline, immediately after, and one week after the procedure. Overall, the results of the study revealed no statistically significant differences in pain and anxiety scores between the two groups at any timepoint. However, VR was found to be significantly more effective in reducing anxiety in teenage boys over 12 years immediately after the procedure (p=0.025). Parents and caregivers reported higher satisfaction with VR, with 100% of caregivers recommending its future use. This suggests that while VR may not significantly reduce pain or anxiety across all pediatric patients, it has specific benefits for certain subgroups and is well-received by both parents and caregivers.