Intra-articular distal humerus fractures remain one of the most difficult injuries to manage. These fractures comprises 2-6% of all fractures and have bimodal age distribution. The majority of these fractures occur either as low energy falls or high energy trauma. Most fractures in elderly patients are intra- articular with bi-columnar involvement. They are commonly multifragmental and occur in osteopenic bone. High energy injuries occur in adults, which are accompanied with other associated injuries. The elbow is anatomically a trocho-ginglymoid joint in which distal humerus bifurcates into two divergent cortical columns, termed as medial and lateral columns. The articular segment functions architecturally as a tie arch. The elbow is one of the most constrained joints of the body and tolerates immobilization poorly and any alteration within the architecture of the joint has the potential to limit motion and compromise function.Treatment outcomes are often related to elbow stiffness, weakness and pain. Meticulous planning is required in obtaining an anatomic intra-articular reduction, and creating a fixation construct that is rigid enough to tolerate early mobilization. Usually, 70% of patients that sustain an elbow fracture, fall directly on to the elbow because they are unable to break their fall with an out stretched arm. This randomized, prospective study was undertaken to compare the functional outcomes of distal humerus intraarticular fractures in adults treated with parallel plates and orthogonal plates. From a clinical perspective, a parallel plating method appears to provide better rigid fixation that is adequate for obtaining bone union. However, no statistical significant differences were observed between the orthogonal and parallel double plating methods in terms of clinical outcomes and complication rates. If meticulously applied, with suitable plates, both parallel and orthogonal positioning can provide adequate stability and anatomic reconstruction of the distal humerus fractures.