Introduction:

Distal humeral fractures in the elderly patient are a therapeutic challenge for orthopaedists, because of age’s characteristic physiological conditions and bone changes.

Case report:

We present the case of an 80-year-old woman with osteopenia, who had distal humeral fracture due to a fall from her own height; she was initially treated conservatively, but by the reason of a non-union, we decided to perform a total elbow arthroplasty, achieving a positive functional result in the four years of postoperative follow-up.

Discussion:

Nonsurgical management is an option for treat humeral fractures in patients with low functional demands or in poor general condition. If the patient does not present the conditions above, or if nonsurgical management fails, a total elbow arthroplasty must be performed, because this method provides a rapid recovering if compared to an open reduction and osteosynthesis material management.