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Abstract Background:Fractures of the lateral condyle of the humerus represent the second most common type of fracture of the elbow in children. Although this injury is seen at all ages, it is predominately observed in children aged between 5 and 10 years. Multiple treatment options are available for these fractures, ranging from simple immobilization for nondisplaced or minimally displaced fracture patterns, to operative reduction and fixation with Kirschner wires (K-wires) or screws for displaced fractures. Because of concerns about the possibility of loss of fixation with brief use of K-wires or occurrence of infection with their prolonged use, we have explored the use of screw fixation for lateral condyle fractures. In theory, screws should be better suited for resisting load in tension, provide more stable fixation, resulting in a higher union rate, with decreased duration of casting (possibly leading to an improved range of motion). Patients and Methods: Our study has been conducted in Cairo university hospitals (KasrAL.Ainy), in the period from march 2019 to December 2019; a comparative randomized controlled study includes 84 patients with pediatric humeral lateral condyle fractures. Patients were divided into 2 groups. group (A) included 42 cases operated upon with open reduction internal fixation by k wires. group (B) included 42 cases operated upon with open reduction internal fixation with partially threaded 4.0 mm cannulated screws.Results :Fractured patients were classified by Milch classifications, in Milch type 1, 16 cases were managed by k wires and 21 cases by screws. In milch type 2, 26 cases were managed by k wires and 21 cases by screws |