Partial articular fractures in the coronal plane of the distal humerus account for 1% of all elbow fractures and 6% of distal humeral fractures. This injury may involve only capitellum or extend to more medial part of the distal humerus as trochlea or medial epicondyle, and can be seen even with ligament injury or elbow dislocation. Treatments have evolved from closed reduction, immobilization, and fragment excision to an option for open reduction and internal fixation with headless cannulated screws, cancellous partially threaded screws and Herbert screws to stabilize the articular anatomy that facilitates early mobilization. According to complexity of the injury, type of the fracture and preoperative planning, one of extensile lateral, posterior (with or without olecranon osteotomy) or anterolateral approaches can be preferred for reduction and fixation of the fracture. If adequate instrumentation and experience are available, arthroscopy assisted fixation can be performed. Clinical studies reporting the outcomes of the patient series following open reduction and internal fixation of the capitellar fractures have demonstrated good and excellent functional results in most of the patients but complications like osteonecrosis, heterotopic ossification or posttraumatic arthritis may be rarely seen.