Etiology, AO/OTA Classification, and Clinical Distribution of Adult Distal Humerus Fractures at a Tertiary Trauma Center

Abstract

ObjectiveDistal humerus fractures occur across a heterogeneous injury spectrum, ranging from low-energy fragility injuries to complex fractures caused by high-energy trauma. Studies examining the epidemiological characteristics or institutional presentation patterns of these fractures remain limited. This study aimed to describe the demographic characteristics, injury mechanisms, and fracture morphology of adult distal humerus fractures treated at a tertiary trauma center.MethodsThis retrospective observational cohort study included adult patients treated for distal humerus fractures between January 2021 and December 2025. Demographic characteristics, injury mechanisms, AO/OTA classification, open fracture status, and the presence of polytrauma were evaluated. Associations between categorical variables were analyzed using the Pearson chi-square test or Fisher–Freeman–Halton exact test, as appropriate. Age distributions across the main fracture types were compared using the Kruskal–Wallis test.Results:A total of 115 patients, including 49 women and 66 men, were included. The mean age was 45.3 ± 19.8 years. Of the injuries, 47.8% were high-energy, 40.9% were low-energy, and 11.3% were moderate-energy. AO/OTA type C fractures accounted for 72.2% of all fractures. Open fractures occurred in 38.2% of high-energy injuries, while the polytrauma rate in this group was 40.0%. Low-energy injuries were more frequent among women, whereas high-energy injuries were more common among men (p