PURPOSE: To compare the results of open fixation and closed percutaneous pinning in managing Jakob stage II lateral condylar fractures of children's elbow. MATERIALS AND METHODS: Since Febuary 2000, We operated 21 children with Jakob stage II lateral condylar fractures of elbow. Eleven of the 21 were treated with closed percutaneous pinning, open fixation was done to the other 10 children. Each patient was evaluated about range of motion, carrying angle, scar satisfaction and radiologic findings for comparison between closed pinning and open fixation groups. RESULTS: Open fixation group showed 3.8 degrees decrease of elbow motion while closed pinning group showed no significant decrease. Carrying angle and radiologic findings were not different between the two groups. Open fixation group expressed dissatisfaction to their scars (average 5.2 cm) whereas all the patients of closed pinning group were satisfied with their functional and cosmetic outcomes. CONCLUSION: In managing Jakob stage II lateral condyle fractures of children's elbow, closed percutaneous pinning was thought to be superior to open fixation because of the same functional outcome and much better cosmetic results.