Complications of iujuries around the elbow joint resulted in chronic pain, limitation of motion, neurologic problems, and deformities and many of them require the operative procedures. In the past the reconstructive surgery on joint itself was hardly considered, so osteotomy for the deformity and neurolysis for the palsy were the common procedures. Recently, in cases of the old injuries of elbow joint, attempts have been made to reconstruct the shape and function of the joint as much as possible to restore the normal joint. The authors reviewed 83 elbow joints of the 82 patients who had operated at the orthopedic department of Seoul National University Hospital from April, 1982 to March, 1990. The cases more than three months from the onset of injury, were considered as old injuries. We clarified the cause of injuries, the associated problems, what problems needed the treatment, such as pain, deformities or limitation of motion. Then we have analysed the results according to the type of operative procedures and original injuries. Males were 54 and females were 28, the age at the time of injuries ranged from the 2.2 years to 72.1 years, the average age was 18.1 years. Left elbow was involved in 43 cases, right in 40 cases. The age at operation ranged from the 3 years to 73 years, the average was 27.7 years. The elapsed time from initial injuries to operation ranged from 3 months to 50 years, the average was 9.7 years; 50 cases were below the age of 15 years and 32 cases were above the age of 15 years. The follow up period ranged from 6 months to 6 years, the average was 1.4 years. In summary, the results are as follows; Firstly, the operative treatments of the elbow injuries were known to have the high complication rate, therefore the indication and methods of operative treatment must be restricted carefully and must be done actively at the time of injuries, if possible. In the case of old injuries, the same principles as above are applied. The procedures such as the osteosynthesis and adhesiolysis that restore the normal joint as much as possible result in better results than arthroplasty in overall assessment. Secondly, the lateral condylar fractures induced the complications more frequently than other irijuries, and it was thought that the trial to get the anatomical restoration by the osteosynthesis was favorable. Thirdly, in the case of the old radial head or radial neck fractures, it is more desirable to do the osteosynthesis than resection of radial head if indicated. It is also important that the fresh fracture, even in comminuted radial head fractures, must be maintained in the accurate anatomical position as possible. Fourthly, the better result came from the immediate anatomical reduction even though the neglected elbow dislocations. Fifthly, tardy ulnar nerve palsy was frequently associated with the old lateral condylar fracture, the dislocation of the elbow and cubitis valgus. The combination of medial epicondylectomy and the neurolysis was proven as better method than the anterior transfer of ulnar nerve.