The incision starts over the lateral supracondylar ridge, 3-5 cm (depending on the age/size of the child) proximal to the elbow joint. It passes distally to the lateral surface of the proximal forearm, posterior to the radial head.
In pediatrics the incision is slightly more posterior compared with the adult approach.
It is always possible to go more anterior from a posterior incision by extending the incision distally and or proximally and undermining.
Note: Care must be taken to protect the radial nerve, which runs close to the radial head and neck. It divides into its superficial and deep branches at the level of the radial head.