34 adult patients were assessed at an average of 15 years (13–20) after stable internal fixation with early active mobilisation of a distal humeral fracture. 23 were Müller type C, (5 open), 9 type B and 2 type A. Using the Mayo Score, 94% had an excellent/good result and 6% fair. None had a poor outcome. This study is the first to demonstrate that early stable internal fixation of distal humeral fractures by an experienced surgeon, gives excellent long term results with few complications, together with high rates of patient satisfaction and little functional morbidity.