Background Fractures of the olecranon are relatively uncommon in children and most are non-displaced or minimally displaced. Wire and suture methods have been used to stabilize displaced pediatric olecranon fractures. This study compares diVerences in the clinical outcome of 15 children either treated with open reduction and screws, tension band suture (TBS), tension band wires (TBW), or plating. Methods The treatment consisted of open reduction and internal Wxation in 15 cases with a mean of 7.6 years of age.Twelve patients underwent stabilization with K-wires and tension band wires or tension band sutures; one patient, isolated K-wires; one patient, screw Wxation; and one patient, plate Wxation. At follow-up, clinical and radiological assessments were made according to Murphy score. Results At follow-up, 7 patients showed excellent results; 3 patients, good results; 3 patients, fair results; and two patients, poor results. Three patients had an extension deWcit of 5°, 2 patients with tension band wires, and one patient with plate. None of the patients had developed non-union. Conclusions Open reduction and internal Wxation leads to satisfactory results in children with displaced olecranon fractures. The most common cause of unsatisfactory results was loss of motion, although this usually did not prevent good function.