comparing surgical outcomes of distal humerus fractures between dominant and non-dominant upper limbs in adults: a retrospective study

Background: distal humerus fractures are relatively rare, accounting for about one-third of humeral fractures and approximately 2% of all fractures in adults. these injuries can significantly impact upper limb function, particularly when the dominant limb is affected. objectives: this study aimed to assess whether involvement of the dominant upper limb, along with factors such as gender and smoking, influences postoperative disability measured by the disabilities of the arm, shoulder, and hand (dash) score.methods: in this cohort study, patients with surgically treated distal humerus fractures were prospectively followed. data on demographic variables, hand dominance, smoking status, and dash scores at follow-up were collected. the primary outcome was the postoperative dash score. statistical analysis was performed to determine the relationship between dominant limb involvement and dash score, adjusting for confounders such as sex and smoking.results: a total of 116 patients were included. dash scores were significantly higher in patients with dominant limb involvement (mean±sd: 37.96±36.25) compared to non-dominant limb involvement (26.21±23.27) (p=0.03), indicating greater disability. female gender (mean dash: 38.36 vs 25, p=0.01) and smoking (mean dash: 45.37 vs 27.53, p=0.007) were also significantly associated with higher disability scores.conclusion: upper extremity disability, as measured by the dash score, is significantly greater when the dominant limb is involved in distal humerus fractures. female sex and smoking are also associated with worse functional outcomes. these findings highlight the importance of considering dominance and modifiable risk factors in prognosis and rehabilitation planning.