Growth disturbances after fractures of the lateral condyle of the distal humerus in children present mostly as transient stimulation of the lateral physis. Clinically lateral condylar overgrowth leads to a radial bony prominence and varisation of the elbow. From 1974 to 1994, 66 fractures were prospectively diagnosed with standard roentgenograms and treated by open reduction and internal fixation with a metaphyseal lag screw in case of displacement. Fifty-four patients (82%) were reviewed with an average length of follow-up of 10 years (range, 2-22 years) to assess all sequelae of growth disturbances. Screw osteoynthesis led to anatomical union, symmetric carrying angles and full range of motion in all 27 operated cases, and proved to prevent stimulating growth disturbances contrary to the common but relatively unstable fixation with Kirschner wires.