Distal humerus fractures with intra-articular comminution are complex injuries. Knowledge of distal humeral anatomy aids in proper exposure and reduction. The diagnostic workup includes radiographs and CT scans to determine the extent of comminution. This video demonstrates exposure, reduction, and provisional and definitive fixation of a distal humerus fracture. Traditional techniques involve reduction of the articular surface first. Our preferred technique for management an AO/Orthopaedic Trauma Association type C distal humerus fracture involves conversion to a type B type injury first. Metaphyseal reduction allows for restoration of column length and alignment of the coronoid and olecranon fossae. Column reconstruction provides a foundation for secondary anatomic reduction and fixation of the articular fragments.