Much of the literature on pediatric orthopedics focuses on the upper extremity - especially on upper extremity trauma. Evaluation of injuries to the skeleton of the growing child can be challenging, especially with regard to fractures about the elbow. The optimal method of attaining and maintaining stability of a given fracture can be controversial as techniques are developed, modified, or abandoned. Neurovascular complications can occur secondarily to upper extremity fractures or to their treatment; recognition and appropriate management of neurovascular compromise is mandatory to optimize results. Another segment of the literature in upper extremity disorders in children deals with congenital anomalies. A rational approach to management of deformity begins with a classification system that identifies pertinent aspects of the deformity relative to treatment. A knowledge of the pathoanatomy specifically as it translates to functional deficit is mandatory. Goals that are well-defined and agreed upon by the physician, patient, and family are more easily achieved. Comparison of results of treatment modalities helps both to identify future candidates and to develop additional operative methods.