Objective To investigate the effect of manipulation and splint fixation combined with staged medication on the efficacy and complications of comminuted fracture of the lower humerus in elderly patients. Methods A simple random number table method was used to divide 80 patients with comminuted fractures of the lower tibia from January 2017 to June 2018 in our hospital into control group and observation group. The control group was treated with minimally invasive plate internal fixation with percutaneous anterior approach. And 40 patients in the observation group who underwent manual suture fixation combined with staged medication, and Mayo elbow joint function score, elbow joint activity, and complication rate between two groups were compared. Results After treatment, the observation group and the control group had similar elbow joint function scores (pain, flexion and extension function, joint stability, daily living function), and the difference was not statistically significant (P > 0.05). Compared with the control group, the fracture healing time was shorter (P < 0.05) and the total incidence of complications were less (P < 0.05) in the observation group. Conclusions Manual suture fixation combined with staged medication and minimally invasive plate internal fixation with percutaneous anterior approach can achieve ideal curative effect, but the former has lower overall complication incidence, shorter fracture healing time. And because of the particularity of patients, manual suture fixation combined with staged medication should be the preferred treatment.