Outcome of primary internal fixation of (type C) distal humerus fractures in the elderly

The aim of this review is to evaluate the functional results of open reduction and internal fixation of AO type C distal humerus fractures in elderly patients. Twenty patients were recruited in this study with an average age of 73.5 years. AO principles were followed, using dual plating in most and inter-fragmentary screws to obtain stable fixation. Mobilisation was commenced on the first post-operative day. Functional results were 72% good or excellent using the index of Broberg and Morrey, and 93% good or excellent using the Mayo elbow performance index. The average loss of full extension was 17.3° (0-30°) and the average flexion was 131° (90-140°). Radiologically, all fractures were united at review although there was few screw loosening and one implant failure at the lateral column but this did not influence the functional outcome. In conclusion, open reduction and internal fixation of type C distal humerus fractures in elderly patients should continue to be the treatment of choice.