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Open reduction and internal fixation of 42 cases of paediatric supracondylar fracture is discussed. All grade III supra condylar fractures were reduced using lateral and/or medial supracondylar approach and fixed with Criss cross K wires from medial and lateral epicondyles. The result were excellent in 36 cases (85%) and poor in 6 cases (15%). The poor results were due to technical errors in surgery. Supracondylar fracture is classified as grade I (undisplaced) and grade-II (displaced) because differentiating grade II from III (Gartlands 1959) is difficult radiologically. The lateral exposure for open reduction of supracondylar fracture has not been described earlier. The posterior approach routinely used for open reduction and internal fixation of fractures around the elbow, when compared with lateral approach is very traumatic and is often associated with stiffness of the elbow.