Extra articular fractures of the distal humeral fractures are rare; however, these injuries require experienced treatment. These kind of fractures in the osteoporotic elderly population are caused generally by falls. The fracture occurs when humerus receives a direct impact while stepping on the elbow in flexion or by axial loading on open arms during a fall. The fracture mechanisms in young adults are mostly the result of gunshot wounds or high-energy traumas due to traffic accidents. Their three-dimensional geometry and being very close to the elbow joint, inadequate subchondral and cancellous bone stock of the patient, and the lack of convenient platescrew systems suitable for the anatomy of that region has been complicating factors for the treatment of these fractures in the past. Nonunion, malunion and stiffness in the elbow joint are common in the surgically treated fractures of this kind. Functional limitations are inevitable if early motion is neglected and proper rehabilitation exercises are not applied after the treatment. As a result, the treatment of the distal humerus fractures are still the fracture type with high complication rates nowadays. The primary reason is lack of knowledge on the classification, anatomy, treatment options, postoperative rehabilitation, and insufficient surgical experience. Surgical revisions are always more difficult after an insufficient and unstable fixation of the fracture primarily done. A reliable rigid fixation that enables early active motion is necessary for a functioning elbow. Clinically excellent functional results can be achieved by rigid fixation with a good surgical technique and patient compliance.