Choke slam needed here.

Instruct Mommy and Daddy that you will take little junior for a walk outside and you will be instructing the little f*cker to pick out a switch that will light his ass up courtesy dear ol Mom and Dad.

I think #35 has a point. If a child does something to physically harm another, they sometimes don't stop until they're hurt the same way. If they're young enough, sometimes they'll take the reaction of the other person being hurt as a joke, and laugh and turn it into a game. Like children who bite others and then laugh and run away, only to return and do it again.

Awe! That kid sounds spoiled

I'd say a spanking is in order.

No. Your sibling and their spouse created that little demonic beast and they are the ones that will control his actions until he learns respect enough to not injure so much as an ant. Feel free to quote me on this.

This little shit kid's mom and dad should pay for the surgery, whether they have home owners insurance or not. Then the need to beat some sense into this kid. Then use him as a poster child for birth control.

Oh my god! I'm so sorry! I just can't believe that little brat would do that much damage!

I do agree that the parents should pay for the surgery and that your nephew needs to have some sort of large consequence. My sister broke her arm and someone's kid yanked on it, causing it to break even further. She was almost done with the cast and had to spend another seven months in a cast. The parents told their son that he had hurt someone and would not also be spending seven months "healing." He was grounded until he cast came off.