Background Open fractures, vascular injuries, and inability of the patient to comply with fracture bracing are indications for surgical fixation of distal third humeral shaft fractures. Surgical approaches for distal third humeral shaft fractures include the triceps-split approach and the para-tricipital approach. Methods The anatomy, examination, diagnosis, and surgical approach options are reviewed. The video presents the case of a 73-year-old woman who had a distal third humeral shaft fracture with a bending wedge fragment extending into the middle third of the humeral shaft. After a thorough discussion of risks, benefits, and prognosis was held with the patient, she elected to proceed with surgical fixation for restoration of function. Results Postoperative clinical outcome showed full and painless shoulder and elbow range of motion. Conclusion Extra-articular distal third humerus fractures can be addressed using the triceps-split approach, as it allows for plate fixation distal to the surgical neck of the proximal humerus and results in reliable union and good functional outcome.