Ununited fractures about the elbow represent uncommon, but complex, reconstructive problems. Skeletal union in anatomic alignment represents the best opportunity for younger, active individuals to regain function and maintain it long term. Stable fixation is difficult to achieve, but the techniques described herein have been used with good results. Capsulectomy and ulnar nerve neurolysis may be essential to a good result, particularly in the treatment of distal humeral nonunions.