Contrecoup Fracture of the Sternum

Tarnowsky, George de

doi:10.1097/00000658-190502000-00007

Cited by 15 publications

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“…All out of the sternal fractures in SVV showed the typical type of dislocation with an override of the corpus atop the manubrium which is consistent to the ones Tarnowsky [1905] and Fowler [1957] reported yet (12,33) (Figure 4A). In consequence the trunk lost its stability in the sagittal plane due to a destruction of the anterior chest wall what subsequently frequently cause concomitant injuries of the vertebral spine in strong impacts to the trunk (12).…”

Section: Discussionsupporting

confidence: 86%

“…Whilst in 1905 no procedures of sternal stabilization were known yet, Fowler fixed the reduced sternum with a K-wire which was placed transcutaneously (12,33). Meanwhile anterior sternal plating has been described as the most reliable procedure since it can be performed following a standard sequence with high safety and dangerous dislocations of wires intrathoracally are eliminated.…”

Section: Discussionmentioning

confidence: 99%

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Do low profile implants provide reliable stability in fixing the sternal fractures as a “fourth vertebral column” in sternovertebral injuries?

Krinner¹,

Grupp²,

Oppel³

et al. 2017

J. Thorac. Dis.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Do low profile implants provide reliable stability in fixing the sternal fractures as a “fourth vertebral column” in sternovertebral injuries?

Krinner¹,

Grupp²,

Oppel³

et al. 2017

J. Thorac. Dis.

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“…From the end of the 19th century up to the mid of the 20th century, fractures of the sternum were mentioned with an incidence of under 1% and increased with the number of car accidents to 5-8% of all bone injuries (1)(2)(3)(4)(5)(6). The number is even higher in multiple trauma patients (3.9% isolated sternum fractures) in combination with other rib fractures (7.8-11.2%) and in flail chest injuries (10.8-21.2%) (6).…”

Section: Introductionmentioning

confidence: 99%

“…The sternum has different fracture types, depending on the injury mechanism since direct blunt trauma, indirect impact, and forced traction of muscles can cause sternal fractures (1). While fractures of the corpus sterni are mainly caused by direct forces, i.e., the impact to the steering wheel, manubrium fractures from other fracture mechanisms appear to be relevant (3,7,8).…”

Section: Introductionmentioning

confidence: 99%

Fractures of the manubrium sterni: treatment options and a possible classification of different types of fractures

et al. 2018

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Background: Sternum fractures are mostly located on the sternal corpus, seldom on the manubrium.Fractures of the sternal manubrium are, however, more frequently associated with severe concomitant injuries of thoracic organs, and therefore deserve special attention. In addition, in its function as a capstone in between the anterior chest wall and the shoulder girdle, it is exposed to a multiplicity of forces. Therefore the questions arise what types of fractures are observed in today's clinical practice, how to classify them and which treatment options are available. This study reports on different types of fractures which involve the manubrium sterni. Methods: Between January 2012 and October 2014, data was collected from all severely injured patients (ISS ≥16), which received a CT scan of the thorax in our Level-I-Trauma Center and retrospectively analyzed concerning sternal fractures. Fracture type, collateral injuries, age, and information about the circumstances of the accident were noted. Results: Of 890 evaluable patients, 154 (17.3%) had a fracture of the sternum and 23 (2.6%) of the manubrium. Fractures of the manubrium appeared in following types: A-type-transverse fracture (n=11) in 1st intercostal space by direct blunt trauma or flexion of the torso with sagittal instability; B-type-oblique fracture (n=9) by seat belt injury with rotatory instability; C-type-combined, more fragmentary fracture (n=3) by direct blunt trauma with simultaneous flexion of the torso and multi directional instability. Fractures only little dislocation were treated conservatively, and unstable fractures were surgically stabilized (n=10). Conclusions: In summary, three main types of fractures could be found. A-type fractures were stabilized with a longitudinal plate osteosynthesis and B-type fractures with transverse positioned plates. To treat complex C-type fractures, plates with a T-or H-form could be a good solution.Level of evidence: Level III retrospective prognostic cohort study

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“…1 In 1864, Gurlt cited a series of 22,616 fractures of all types; among them were only 22 cases of uncomplicated fracture of the sternum caused by indirect violence. 2 Different mechanisms have been reported, among which are muscle contraction 3 and labor, 4 but the most frequent cause of sternal fracture is the forceful impact of the sternum against the steering column of an automobile after a rapid deceleration. 5,6 Seat belts have been blamed in many studies.…”

mentioning

confidence: 99%

Sternal Fracture – Regional Experience

Batouk

1996

Ann Saudi Med

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A retrospective analysis of 27 sternal fracture patients out of 267 patients with chest trauma was done in the period between March 1990March (9-1410 and April 1994April (11-1414 at Asir Central Hospital, giving an incidence of 10% in all chest trauma. There were 25 males and two females, giving a ratio of 12.5:1. The age range was 18-70, with a mean age of 37.5 years and a median age of 35 years. The mean hospital stay was 12.2 days, with a range of 3 to 53 days and a median of seven days. The mechanism of injury and the types of associated injuries are presented. Twentyeight percent of the sternal fracture patients had abnormal electrocardiogram. Echocardiogram was done on only eight patients (32%); two were abnormal. Ann Saudi Med 1996;16(3):285-290. A Batouk, Sternal Fracture -Regional Experience. 1996; 16(3): 285-290 In 1751, Du Verney reported an exceptional case of compound fracture of the sternum in a quarry man.1 In 1864, Gurlt cited a series of 22,616 fractures of all types; among them were only 22 cases of uncomplicated fracture of the sternum caused by indirect violence.2 Different mechanisms have been reported, among which are muscle contraction 3 and labor, 4 but the most frequent cause of sternal fracture is the forceful impact of the sternum against the steering column of an automobile after a rapid deceleration. 5,6 Seat belts have been blamed in many studies. 7-9The bone injury itself has generally been reported as being inconsequential. The degree of association of sternal fracture with other types of injury, such as myocardial, major thoracic, vascular and spinal, is, however, significant. 10-18Our objectives are to determine the incidence, morbidity and mortality of patients with fractures of the sternum, to identify specific features of the sternal fracture which may predict the outcome, and to identify the factors that affect the duration of hospital stay in patients with sternal fracture. MethodsAsir Central Hospital is a 450-bed hospital in Abha City, located in the southwestern region of Saudi Arabia. It is a tertiary hospital, Level II Trauma Center, with a catchment population of one million.Data were collected from the medical records of 267 patients with chest trauma between March 1990 (9-1410) and April 1994April (11-1414, of whom 27 patients had sternal fracture. These were analyzed with regard to demographics, area of sternal fracture, admission electrocardiographic (ECG) and echocardiographic changes, treatment modalities and outcome of treatment.ECG was classified as abnormal when there were arrhythmias, conduction defects, nonspecific ST segment or T-wave changes, evidence of anatomical specific ischemia, sinus tachycardia or any other abnormality interpreted by a cardiologist. Chi-squared, two-tailed, Fisher's exact and Mann-Whitney-Wilcoxon tests were used as tests of significance at a 5% level of significance. ResultsDuring the four-year study period, there were 267 patients who sustained chest trauma, among whom 27 were found to have sternal fracture, giving an ...

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Contrecoup Fracture of the Sternum

Cited by 15 publications

References 0 publications

Do low profile implants provide reliable stability in fixing the sternal fractures as a “fourth vertebral column” in sternovertebral injuries?

Do low profile implants provide reliable stability in fixing the sternal fractures as a “fourth vertebral column” in sternovertebral injuries?

Fractures of the manubrium sterni: treatment options and a possible classification of different types of fractures

Sternal Fracture – Regional Experience

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