Six patients with a shear fracture of the capitulum humeri were treated in the Orthopaedic Unit at Kassar Said, Tunis, between 1968 and 1971. Three patients had immediate excision of the fragment, all with good results. The other three, in whom removal of the fragment was delayed for several months, were improved over their preoperative condition, but they did not have as good results as those seen in the patients who were treated promptly. Immediate removal of the fragment is preferred over open or closed reduction because of the difficulties of fixation of the small, articular fragment, and the possibility of avascular necrosis.