Abstract:
Introduction. Transcondylar fractures of the humerus are the most frequent fractures at the level
of elbow facing children. These can be extremely difficult to manage and if the way if treatment
is not correct, then complications such as joint stiffness could appear.
Aim of study. Appreciation of diagnostic features and treatment of transcondylar fractures in
children.
Methods and materials. This study included 115 patients with ages varying between 3 years to
18 years old, 75 boys and 40 girls, who presented themselves to IMSP Mother and Child Institute
from Chisinau, department of Orthopedics, Traumatology and Vertebrology between 2021 and
2022. All these children were subject to transcondylar fractures of the humerus.
Results. Patients have been categorized by gender: 40 girls (35%) and 75 boys (65%). In 63 of the
children (55%) the upper side of the right member has been affected, while in 52 children (45%)
has been affected the upper side of the left member. Considering the symptomatic point of view,
the most common sign of all has been the significant pain (100%) to the affected member. Other
clinical characteristics have been such as oedema (100%) and hematoma (85%). The diagnosis
was given based on the clinical examination and radiological assessment of the affected member
in two incidents (front and lateral). The I-III grade fractures (Lagrange-Rigault Classification) have
had indication for orthopedic treatment (37%), while the IV-V grade fractures have had indication
for surgery (63%). After the surgical interventions, they have undergone treatment with antibiotics,
inflammatory, local treatment with aseptic dressings. The threads have been removed on day ten.
The duration of 80% from the surgeries has been around 30-40 minutes. The plaster cast
immobilization was kept 3 weeks, after which it was removed together with brooches. The
recovery treatment after the removal of immobilization contained physical therapy and light
massage.
Conclusion. Transcondylar fractures are predominant for masculine gender and mainly affected
is the right upper member. Orthopedic treatment is recommended for I-III grades (Lagrange Rigault Classification), while the surgery is compulsory in IV-V grades or in case of failure in
orthopedic treatment. The cases with late diagnosis (over 3-5 days after the trauma) need surgical
intervention to reconstruct the elbow joint.
