Peer review has expired on this program. It is the viewer’s responsibility to determine the educational value of this historical content.Peer review has expired on this program. It is the viewer’s responsibility to determine the educational value of this historical content.Pediatric supracondylar humerus fractures are common injuries. The treatment begins with an evaluation to assess the patient’s overlying skin for open fractures and bruising or puckering of the skin, which may indicate more severe trauma and possible difficulty with achieving an adequate closed reduction of the fracture. A thorough neurovascular exam must be documented, followed by radiographs and splinting. Determining whether operative treatment is required, as well as the timing of surgery, is based on radiographs and physical exam. Using the proper surgical equipment, setup, and patient positioning are crucial for successful treatment. The reduction maneuver is followed by percutaneous pinning and casting. This video demonstrates the physical examination, operating room setup, patient positioning, as well as postoperative care. The technique for reduction maneuver and pin placement and configuration are detailed. Common pitfalls and complications, such as vascular compromise, neurologic injury, loss of reduction, and techniques to avoid these are covered. Difficult cases?with pearls for successful treatment?are also presented.