Objective To research operative procedure, results and complications of treatment of the intra-articular distal humeral fractures.Methods 16 cases of these fracture were fixed operatively through a posterior approach with plates on both the medial and the lateral column in adults, and Kirschner wires in children. Results 15 patients were followed up for 5～36 months, the fractures healed in 1 2～6 5 months.Complications as follows: each electric burn of skin, superficial infection, palsy of ulnar nerve, loss of screws and non-union in one case, stimulation of Kirschner wires in 2 cases. Conclusions Triceps-splitting,elbow posterolateral approach or olecranon osteotomy are well suited to the exact visualisation and accurate reduction of this difficult fracture with minimal damage.The election of interfixation model should base on the age and the fracture type.