Fishtail deformity is a rare but vexing complication of pediatric elbow fractures. Clinical presentation with loss of motion and/or pain is often delayed. Arthroscopic debridement may improve symptoms in the short term, but long-term prognosis is guarded. Subluxation of the radial head is associated with worse functional results. Early detection and surgical strategies to prevent proximal migration of the forearm and development of ulnotrochlear incongruity, radial head dislocation, and impingement may improve outcomes in patients with fishtail deformity.

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