We report the results of 75 patients with type C intra-articular fracture of the distal humerus treated operatively by two methods and followed up for a mean period of 48.2 months. Minimal osteosynthesis and joint immobilization was used in 21 cases while the remaining 54 patients were treated according to AO recommendations. Good or excellent results were found in 38 per cent after minimal osteosynthesis and in 77.8 per cent following the AO technique. 87.8 per cent of the cases with stable osteosynthesis and early mobilization had a good or excellent result as compared with 41.2 per cent of the cases after unstable fixation and immobilization of the joint (P < 0.01). The type of fracture was found to be an important factor in achieving stable fixation (P < 0.01).