This video demonstrates the technique for open reduction and internal fixation of displaced pediatric lateral condyle fractures of the humerus. Initial evaluation begins with an examination, followed by radiographsthat include an internal oblique view. The classification system, as well as operative indications, are reviewed. The operating room setup is then described in detail, including patient positioning and equipment needed for the procedure. We then describe our preferred technique, including the exposure and tips for accurate reduction. Understanding the blood supply to the distal humerus is imperative to avoid avascular necrosis. Fixation options are described, as well as complications that can arise from inadequate fixation. Finally, we review our postoperative protocol, and conclude with some take-home points.