Abstract

Objective: To evaluate the clinical outcomes and functional recovery of elderly patients who underwent open reduction and internal fixation for intra-articular distal humerus fractures at a major trauma center in Pakistan.
Methodology: This retrospective cross-sectional study was conducted at the Shaheed Mohatarma Benazir Bhutto Institute of Trauma in Karachi from February 2018 and February 2023. Data from 34 patients aged 60 and above who underwent ORIF were analyzed. Functional outcomes were assessed using the Mayo Elbow Performance Score at 6-month follow-up. Complications were also recorded.
Results: Mean patient age was 65.91±4.07 years, with a female predominance 19 (55.9%). Radiological reduction was satisfactory in 27 (79.4%) of cases. Complications included heterotopic ossification 1(2.9%), implant failure 2 (5.9%), and non-union 4 (11.8%). The Mayo Elbow Performance Score assessments at 6 months showed excellent outcomes in 18 (52.9%) of patients, good outcomes in 8(23.5%), fair outcomes in 1(2.9%), and poor outcomes in 7(20.6%).
Conclusion: ORIF remains the preferred treatment for intra-articular distal humerus fractures in elderly patients, providing reliable functional recovery despite osteoporosis and fracture complexity. Precise surgical technique and structured rehabilitation enhance outcomes, with minimal complications. Larger multi-center studies with extended follow-ups are needed to further validate these findings.

Key words: Distal humerus fracture, elderly, Mayo elbow performance, open reduction internal fixation, osteoporosis, radiological assessment.