Our first patient was a four-year-old Kashmiri boy, who had pain and deformity of the right elbow. The child had received trauma to the elbow six months previously. On physical examination, a prominent radial head and mild limitation of supination and pronation were seen. Our second patient was a six-year-old Kashmiri boy. He had a history of elbow trauma one year previously, for which he had not received any treatment at the time. In both cases, an anterolateral dislocation of the radial head was confirmed by radiography. An underlying ulnar injury in both our cases was suspected because of the loss of proximal convexity of ulna.We chose a procedure (the Ilizarov technique) that would produce controlled lengthening and hyperangulation in two planes to restore the radiocapitellar articulation without open reduction and reconstruction of annular ligament. The procedure was explained to both sets of parents and written informed consent obtained from them. Approval from the institutional ethics board was also obtained. Radiographs in both anterio-posterior and lateral view were studied to assess the dislocation of the radial head. Because the dislocation in both of our patients was an anterolateral one, an osteotomy in the proximal ulna and differential lengthening in two planes was planned to create a medial and posterior hyperangulation, to place the radial head in the appropriate radiocapitellar orientation. We hoped to avoid open reduction of the dislocation and reconstruction of the annular ligament. The surgery was undertaken under general anesthesia. A two-ring construct with hinge application was used. The ring was fixed only to the ulna, to allow free supination and pronation movement. The proximal ring was fixed with an Ilizarov wire and one half-pin. The distal ring was fixed by two half-pins in different planes on the subcutaneous border. Through an incision 15 mm long, a low-energy corticotomy of the ulna was performed at the proposed site. We did not make any attempt to hyperangulate the ostotomy intraoperatively. Distraction was started on the seventh day after surgery in a differential manner, to create lengthening and hyperangulation in two planes as planned. We followed up the progress of our patients every week with both clinical and radiologic examinations to assess the lengthening, angulation and relocation of the radial head. For our first patient, relocation of the radial head was confirmed both clinically and by radiography by the third postoperative week. Relocation took longer for our second patient, being achieved by the fifth postoperative week and involving lengthening of the ulna by 15 mm. Both patients were encouraged to perform range of motion exercises of the elbow, and the frame was left in place until maturation of the regenerated bone. The ring was finally taken off at six weeks for our first patient and at 12 weeks for our second patient; for both, a protective long arm cast was applied for another two weeks. The regenerated bone healed at an average rate of three weeks/cm. The radial head maintained the reduced position without annular ligament reconstruction. At follow-up two years after surgery, both patients had an excellent result and 100% range of motion around the affected elbow.