This is a case of congenital elbow flexion contracture in a 4-year-old boy. The contracture, with the range of motion (ROM) 160/80/0, was successfully corrected using the minimized orthopedic hexapod Ortho-SUV Frame (OSFm) on the base of calculation in the multi-total residual mode of the OSFm software. Multi-total residual mode of OSFm software ensures accurate movement of a mobile (corresponding) bone fragment according to any given trajectory. This mode helps to make contracture correction using multiple intermediate positions of the distal articular surface according to the normal kinematics of the elbow joint. Firstly, distraction 5 mm in the elbow was calculated to provide the gap between joint surfaces. Then correction was planned by gradual multiple motions of 5-10° using the center of humerus trochlear block as a center of rotation. Each of these steps was clearly visualized by the software. The correction took 26 days. Then the elbow was stabilized with the frame in the fully extension position for 2 months. After dismantling the rings, the elbow joint was fixed with an orthosis for the first 3 weeks. The 6 months in the orthosis (at night only) was combined with exercise therapy. The resultant ROM was 160/20/0. © Springer Nature Switzerland AG 2015, 2024.