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Elbow dislocations can lead to a variety of deep distal fractures near the articular joint. Shear fractures of the condyles, the capitulum and the trochlea can be involved to varying extents. These complex fractures cannot always be classified and treated according to the standard AO principles. The present article retrospectively analyses 30 such cases in order to develop diagnostic and treatment recommendations while taking the literature into consideration. Preoperative CT scan is mandatory, since conventional X-ray is often unable to evaluate the extent of trauma. Tomography is fundamental to decision-making and leads to solid preoperative planning for surgical exposure and optimal implant placement. Moreover, the prognosis for healing depends on the size of articular fragments. In terms of choice of implant, cannulated 3.5 screws placed via temporary K-wire fixation have proven their effectiveness. Outcome according to the Morrey Score shows that, although deformities are seen, fractures heal with satisfying results (>75 points) in 90% of cases. [ABSTRACT FROM AUTHOR]