When avulsion of the medial humeral epicondyle is associated with dislocation of the elbow, the management of the epicondyle is controversial. Some authors consider that open reduction and internal fixation of the epicondyle is indicated only for the unstable elbow, for an epicondylar displacement, or for intra-articular incarceration of the fragment. But others advocate open reduction and internal fixation of the epicondyle in all cases to prevent possible development of unstable elbow. We report prospective results of 12 patients who had open reduction and internal fixation of the epicondyle after initial closed reduction of the elbow dislocation from Jan. 1983 to Dec. 1989. The advantages of open reduction of epicondyle were ;1. Management of associated injury such as intraarticular chondral or osteochondral lesion. 2. Early joint motion exercise. 3. Prevention of possible development of the elbow instability.