Lateral humeral condyle fractures (LHCFs) are the most common intra-articular fracture occurring at the elbow in children, with a reported incidence of 12 % to 20 % of all pediatric upper extremity fractures [1]. In the treatment of intra-articular fractures, the principal objective is to attain anatomical reduction, and surgical interventions are frequently recommended when the fracture is displaced by more than 2 mm on plain radiographs [2]. The conventional treatment method for displaced pediatric LHCFs is open reduction and percutaneous pinning. Nevertheless, there are concerns regarding potential complications, such as avascular necrosis, nonunion, elbow stiffness, and unaesthetic scars [3].

Closed reduction and percutaneous pinning (CRPP) have emerged as a viable alternative to open reduction in the treatment of pediatric LHCFs [4,5]. Even in cases with severely displaced and rotated fractures, the utilization of CRPP has shown satisfactory clinical and radiographic outcomes [6,7]. The closed reduction technique relies on intraoperative continuous fluoroscopy, arthrography, or dynamic ultrasound monitoring [8]. However, it is essential to acknowledge that these imaging techniques serve to indirectly guide the reduction process. Discrepancies between the images and the actual articular surface can potentially lead to unpredictable outcomes [9].

Arthroscopically assisted closed reduction to treat LHCFs offers distinct advantages compared to both open reduction and closed reduction. It is a minimally invasive procedure in contrast to open reduction, while additionally providing the benefit of direct visualization that is lacking in closed reduction [10].

However, due to the technical demands associated with pediatric fracture management and arthroscopy, there are limited studies reporting the utilization of arthroscopy-assisted closed reduction for pediatric LHCFs [11,12]. We, therefore, aimed to assess the efficacy of arthroscopically assisted reduction for LHCFs with displacement greater than 4 mm, encompassing cases with fragment rotation. We did not use 2 mm as a cutoff, because most fractures displaced by 2–4 mm have an intact cartilage hinge and closed reduction provides a satisfactory prognosis [13]. In addition, we formulated a modified arthroscopically assisted reduction procedure for both simple displaced LHCFs (Jakob II) and cases involving displacement and rotation (Jakob III), aiming to increase the utility of this procedure and minimize associated complications.