Association Between Surgical Timing and Clinical Outcomes in Elbow Fracture Management.

Background Elbow fractures, including distal humerus, radial head and neck, and olecranon injuries, pose significant surgical challenges due to complex anatomy and the high risk of postoperative stiffness. Early fixation has been advocated to restore alignment and enable early mobilization, but concerns regarding soft tissue readiness and patient optimization often delay intervention. The 48-hour threshold for surgical timing was selected based on biological reasoning-intervening during the early inflammatory phase to minimize periarticular fibrosis-and logistical feasibility within tertiary-care systems, where this window allows adequate preoperative preparation and resource allocation. This study aimed to evaluate the effect of early (<48 hours) and delayed (48 hours-14 days) surgical fixation on functional outcomes and postoperative complications following elbow fractures. Methods This prospective observational study included patients aged 12 years and above who presented with acute distal humerus, radial head or neck, or olecranon fractures within 14 days of injury. Only closed or Gustilo-Anderson type I open fractures were included. Patients were classified into early (<48 hours) and delayed (48 hours-14 days) surgery groups. The reasons for surgical delay, medical, logistical, or soft-tissue related, were documented. Functional recovery was assessed using the Mayo Elbow Performance Score (MEPS) at six months, and postoperative complications were recorded. Statistical analysis included