86 children with 87 lateral condyle fractures were reviewed. Excellent clinical outcomes in 88.9% of Type 1 undisplaced or < 2mm displaced fractures treated by simple cast immobilisation.

In the Type 2 displaced fractures (2–3mm) treated by cast immobilisation, the risk of secondary displacement was 44%

Conclusion: Undisplaced or < 2mm displaced fracture can be treated conservatively in plaster immobilisation.

For 2–3mm displaced fracture, we recommend percutaneous pinning or open reduction and Kirschner wire fixation.

For displaced or rotated fractures, the fragment should be reduced anatomically and fixed with K wire until radiological union.