Abstract:[Objective] To compare the clinical outcomes of open reduction and internal fixation (ORIF) with Kirschner wire versus headless screw for humeral capitellar fractures in adolescents. [Methods] From September 2017 to April 2021, a total of 22 adolescents un- derwent ORIF for capitellar fractures. According to preoperative doctor-patient communication, 12 patients had fracture fixed with Kirsch- ner wire (KW) , while the other 10 patients were treated with headless screw (HS) . The clinical and imaging documents were compared be- tween the two groups. [Results] All the patients were successfully operated on with no significant differences in operative time, incision length, intraoperative blood loss, number of fluoroscopy and hospital stay between the two groups (P＜0.05) , but the HS group got signifi- cantly higher hospitalization cost than the KW group (P＜0.05) . At the latest follow up lasted for (31.04±4.05) months on average, all the ad- olescents in both groups got good appearance of elbow, without obvious varus deformity, and limitation of elbow flexion, and there were no significantly differences in terms of Mayo and Quick-Dash score between the two groups (P＜0.05) . Radiographically, there were no signifi- cant differences in fracture reduction quality, radiographic fracture healing time, as well as the carrying angle and humeral-capitellar angle measured on radiographs at the latest follow up between the two groups (P＞0.05) . [Conclusion] Both Kirschner wire and headless screw used for internal fixation do achieve satisfactory clinical outcomes for humeral capitellar fractures in the adolescents