The treatment of choice of Mason type-II fractures is open reduction and internal fixation. Fractures of the radial head should be stabilized with either cortical screws (1.2–2.0 mm) or resorbable pins. Attention must be paid to the safe zone. The safe zone is the nonarticular part of the radial head that does not come into contact with the sigmoid notch of the proximal ulna during forearm rotation. With the forearm in neutral position, the safe zone is centered 10˚ anterior to the lateral side of the radial head. When the screws need to be placed outside the safe zone, they should be countersunk beneath the articular surface. Alternatively, headless compression screws can be used to avoid soft tissue irritation and interference during forearm rotation. Radial neck fractures can either be stabilized by crossed screws or, especially in case of metaphyseal defects, by plates. Plates should be placed in the safe zone, too. Low-profile plates should be used to avoid soft tissue irritation, especially of the annular ligament. Screws inserted in the radial head should not penetrate the contralateral cartilage because the screw tip would then come to lie within the proximal radioulnar joint and may there damage the cartilage. As a significant amount of the radial head’s blood supply is running through the periosteum, extensive detachment during ORIF should be avoided. If the fragment is not amenable to refixation, fragment resection can be performed for fragments smaller than 25 % of the radial head’s surface. Good results can be expected from ORIF of Mason II fractures.