Background and objectiveTreating transcondylar humeral fractures in elderly individuals remains a challenge in trauma surgery, with plate fixation being one potential treatment method. This retrospective study was conducted to assess the effectiveness of plate fixing through a posterior approach in elderly individuals suffering from distal humeral fractures.MethodsThis retrospective study involved 28 older participants aged ≥65 years with low transcondylar fractures of the humerus (AO/OTA 13A2-3 fractures). We used the 90-90 orthogonal method for treatment. The inclusion criteria were as follows: (1) low transcondylar type of distal humeral fractures (13A2-3 according to the AO/OTA classification system), (2) patients aged ≥65 years, and (3) a follow-up period of at least 12 months. The exclusion criteria were as follows: polytrauma, pathological injuries, chronic elbow osteoarthritis or degenerative arthropathy, and fractures impacting the articular surface of the distal humeral. Clinical outcomes were assessed in terms of the visual analog scale (VAS) score, Mayo Elbow Performance Score (MEPS), and range of motion (ROM) of the elbow joint.ResultsThe mean age of the patients was 72.25 years (range: 65-81 years), of which 14 (50%) were female and 14 (50%) were male. The mean VAS score for pain was 2.7 (range: 0-6). The mean angle of flexion was 130.6o(range: 115-140o), and the mean angle of the extension was −27.7 (range: −21 to −34). Regarding MEPS, 23 patients had an excellent score, four patients had a good score, and one patient had a poor score. There were four complications (two major and two minor) in the patients involved in the study.ConclusionBased on our findings, 90-90 plate fixation for low distal humeral fractures is associated with a high union rate and satisfactory clinical outcomes. Although we found complications in four patients, their healing was not affected. Therefore, we concluded that through improved monitoring and care, we could overcome such complications, and they did not affect the healing of the bone.