Flexion-Compression Injury of the Sternum

Fowler, Allan

doi:10.1302/0301-620x.39b3.487

Cited by 96 publications

(74 citation statements)

References 12 publications

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“…Also, transverse fractures of the manubrium sterni or of the corpus can be caused by car accidents, for example the classic steering wheel injury, which is characterized by a mostly high transverse fracture of the sternum and bilateral rib serial fracture, leading to the unstable anterior chest wall similar to a traumatic pectus excavatum (11,12). As a result of the severity of the influence on the human body, the number of ribs involved as well as the number of fractures per rib usually increase so that instability can be increased to a dramatic extent and become life-threatening.…”

Section: Introductionmentioning

confidence: 99%

The Operative Management of Flail Chest Injuries with Concomitant Sternal Fracture

Schulz-Drost¹,

Krinner²,

Langenbach³

et al. 2017

chr

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RezumatDate generale: Leziunile de volet costal (FCI) sunt unele dintre cele mai grave leziuni toracice. Mai mult decât atât, o fractură de stern suplimentară (SF) chiar agravează rezultatele, cum ar fi durata ventilaţiei mecanice, prin urmare o fixare chirurgicală a fracturilor poate fi luată în considerare în anumite cazuri pentru a grăbi deconectarea ventilatorului. Această lucrare urmăreşte să sublinieze managementul diferitelor tipuri de SF în FCI. Metode: Toate cazurile tratate chirurgical (2012)(2013)(2014)(2015)(2016) Original ArticleCuvinte cheie: volet costal, fractură de stern, fractură sternală, fractură costală, osteosinteză cu placă blocată, Matrix Rib Abstract Background: Flail Chest Injuries (FCI) are one of the most severe thoracic injuries. Moreover, an additional sternal fracture (SF) even worsens the outcome, such as the duration of mechanical ventilation, therefore an surgical fixation of the fractures could be considered in certain cases to improve the weaning from the ventilator. This paper aims to emphasize on the management of different types of SF in FCI. Methods: All surgically treated cases (2012)(2013)(2014)(2015)(2016) that showed the combination of FCI and SF have been evaluated for their clinical details, the morphology of the fractures and the technical aspects of the surgical procedure in a retrospective investigation.Results: All of the SF (n=15) had been fixed by locked plate osteosynthesis through a median approach in a supine position. Three main regions of the sternum showed the need for different fixation strategies: the upper manubrium, central and lower corpus sterni. Concomitant rib fractures were addressed either through the same approach or through additional limited incisions. Conclusions: Combinations of SF and FCI are high risc injuries with high demand on surgical skills. They can be properly fixed with a locking plate osteosynthesis through a combination of limited incisions employing different types of plates depending on the type of SF.

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Section: Introductionmentioning

confidence: 99%

The Operative Management of Flail Chest Injuries with Concomitant Sternal Fracture

Schulz-Drost¹,

Krinner²,

Langenbach³

et al. 2017

chr

View full text Add to dashboard Cite

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“…[39][40] As the thorax is a closed system, injuries to one element should alert one to the possibility of damage to another element, e.g., the spine. [16][17][18] Our incidence of thoracic spine fracture in association with sternal fracture was 5.5% lower than previously reported studies. 16,26 Isolated sternal fracture was seen in one-third of the patients and had a shorter mean hospital stay of 5.8 days (P=0.005).…”

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confidence: 79%

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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“…Direct force applied to the thorax can result in posterior luxation of the sternum on the manubrium, and traumas caused by car steering wheels are a particularly common cause of such injuries (5,11) .…”

Section: Discussionmentioning

confidence: 99%