To investigate the method and cl inical effect of double-plating fixation in treatment of distal humerus fractures. Methods From April 2003 to January 2009, 21 patients with distal humerus fracture were treated with l imited contact compression plate and reconstruction plate via posterior elbow incision and approach inside and outside the edge of both sides of the triceps. There were 12 males and 9 females, aged from 20 to 63 years (39 years on average). The causes of injury were fall ing in 13 cases, traffic accident in 6 cases, and fall ing from height in 2 cases. According to the classification of Association for the Study of Internal Fixation (AO/ASIF), 8 cases were classified as type 12-B1, 2 as type 12-B2, 7 as type12-B3, 3 as type 13-A2, and 1 as type 13-A3. The course of disease averaged 4.8 days. Results Secretion was observed at incision in 1 case 2 weeks after operation, and incision healed after dressing change; other incisions healed by first intention. Transient numbness of ring and l ittle fingers occurred in 2 cases 2 days after operation; no iatrogenic nerve paralysis occurred. All patients were followed up 13 to 18 months (15 months on average). The X-ray films showed bone healed 6 months after operation. No postoperative joint adhesion occurred, and the motion of elbow joint ranged from 0° to 135°. According to Morrey evaluation standard, the results were excellent in 17 cases, good in 2 cases, and fair in 2 case; the excellent and good rate was 90.5%. Conclusion Double-plating fixation has the advantages of wide indications, rigid internal fixation, and significant curative effects in treatment of distal humerus fractures.