Simultaneous Surgical Treatment of Sternum and Costal Cartilage Fractures

Abstract

There are studies confirmed that for severe flail chest or sternal fractures, even multiple rib fractures, surgery can effectively reduce hospital stay and relieve chest wall pain. But it is a challenge to fix too many costal cartilage fractures in such a small area if we just put internal fixator directly on the sternum. Through this case report we want to share our method of fixation of multiple costal cartilage and sternal fractures at the same time through a small incision, and it is also appropriate for multiple costal cartilage fractures without sternal fracture.

Surgical treatment of costal cartilage fractures with titanium plate internal fixation

“…The technical document of Johnson and Johnson just recommends attaching the internal fixator to the bony component. Therefore, we chose to fix both ends of internal fixation materials to the surface of ribs and the sternum, respectively [ 7 ]. Meanwhile, costal cartilages were fixed with screws after reduction.…”

Costal cartilage fracture: A commonly missed thoracic injury in trauma patients

“…The majority of patients are managed conservatively with analgesia [5] . In some cases, patients may undergo surgical plate fixation [ 9 , 10 ]. The natural prognosis of CC fractures is also unknown, particularly whether these fractures will heal to form a stable union or remain a concern for possible instability of the thoracic wall [11] .…”

Sternal Fractures due to Blunt Chest Trauma

“…There were 28 (50%) case reports, 5,6,12,[16][17][18][19][23][24][25][26][29][30][31][32]38,39,41,42,[50][51][52][53][54][55][56]58 5 (8.9%) small case series, 8,13,27,28,48 2 (3.6%) prospective, 21,57 and 21 (37.5%) retrospective studies. 4,7,9-11,14,15,20,22, 33-36, 40, 43-47, 49, 59 Patients aged 48.8 ± 19.6 (range, 6-92; median, 52) years (n=73).…”