Surgical Repair of a Chronic Traumatic Sternal Fracture

Sternal fractures

“…Surgery if indicated should include bone grafting and internal fixation (Mayba, 1986;Hendrickson et al, 1996;Bertin et al, 2002;Wu et al, 2004;Gallo et al, 2006). Sternal dislocation can follow both direct and indirect injuries.…”

“…Rarer complications include non-union where persistent features of pain, tenderness and clicking raise awareness (Holderman, 1928;Mayba, 1986;Wu et al, 2004;Gallo et al, 2006;Grosse et al, 2007). Surgery if indicated should include bone grafting and internal fixation (Mayba, 1986;Hendrickson et al, 1996;Bertin et al, 2002;Wu et al, 2004;Gallo et al, 2006). Sternal dislocation can follow both direct and indirect injuries.…”

Treatment of Chronic Nonunion of a Sternal Fracture With Teriparatide

“…Symptomatic posttraumatic sternal nonunion is a very rare condition with only a few cases reported in the literature. [1][2][3][4] Nonunion of a sternal fracture is defined as a persistent fracture after 3 months 2 or 6 months 1 without evidence of healing in the absence of infection. Risk factors are similar to nonunion in other long bones and include steroid medication use, diabetes mellitus, obesity, poor bone quality, chronic pulmonary obstructive disease, previous irradiation of the chest, decreased vascularization of the bone fragments, and instability.…”

“…If surgical therapy is indicated, they are typically treated by osteosynthesis plating with or without autogenous bone grafting. [1][2][3][4] For more than 17 years, teriparatide (PTH ), a genetically engineered recombinant fragment of human parathyroid hormone (PTH), has been used to treat osteoporosis in men and women who are at a high risk for fracture. This drug has bone-forming effects, and it has been also investigated for the acceleration of fracture healing or in cases of nonunion, both in experimental and human studies.…”

Case Report: Surgical Management of Painful Manubriosternal Pseudoarthrosis

“…While surgery for sternal fracture after acute trauma is rare, surgical repair of painful chronic non-union after sternal fracture has been described (6), as has surgery for chest pain after poorly healed median sternotomy in cardiac surgery resulting in malunion or pseudoarthrosis (7).…”