The Utility of 3-D CT Scan in the Diagnosis and Evaluation of Sternal Fractures

Kehdy, Farid; Richardson, J. David

doi:10.1097/01.ta.0000204938.46034.f4

Cited by 19 publications

(11 citation statements)

References 3 publications

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“… 10 Moreover, sternal fractures may be missed when displacement is minimal, and only conventional radiography is used. 11 12 In case of tiny sternal fractures, sonography has a higher diagnostic sensitivity and specificity than conventional chest X-ray. 11 In our two cases, lateral chest X-ray missed the sternum fracture in one child.…”

Section: Discussionmentioning

confidence: 99%

Sternal Fracture in Children: Diagnosis by Ultrasonography

Sesia

Prüfer

Mayr

2017

European J Pediatr Surg Rep

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Because of its subcutaneous location, the sternum can be examined sonographically using a linear scanner. We report about two children who experienced blunt chest trauma. Anterior–posterior chest X-rays were normal. Ultrasonic imaging confirmed a fracture of the sternum with dorsal displacement of the distal fragment (by 0.97 cm) in the first child and a transverse fracture of the body of the sternum without displacement in the second child. In both children, pericardial effusion was excluded by sonography. The displaced fracture of the sternum was confirmed by magnetic resonance imaging (MRI), which ruled out concomitant injuries of the soft tissues adjacent to the sternum. Both sternum fractures were managed nonoperatively. These cases serve to emphasize the importance of sonography that represents an ionizing radiation free, noninvasive, efficient, and safe imaging modality to diagnose fractures of the sternum in children while also enabling the assessment of the pericardium.

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Section: Discussionmentioning

confidence: 99%

Sternal Fracture in Children: Diagnosis by Ultrasonography

Sesia

Prüfer

Mayr

2017

European J Pediatr Surg Rep

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“…Another reason to run a CT-diagnosis particularly with the relevant injury mechanisms and/or clinical symptoms was reported in 2004 by the authors Kehdy and Richardson, Nakae et al, as well as by Alkadhi et al [9,10,20]. The radiological diagnostic without contrast medium through the use of chest X-ray in two axes cannot reliably and effectively detect a manubrial fracture.…”

Section: Summary and Conclusion Treatmentmentioning

confidence: 92%

“…In the first case Kehdy described a multiple oblique fracture of the sternum involving the manubrium and the cranial part of the corpus sterni [9]. The second case was described by Nakae in 2002.…”

Section: Introductionmentioning

confidence: 95%

The oblique fracture of the manubrium sterni caused by a seatbelt—a rare injury? Treatment options based on the experiences gained in a level I trauma centre

Schulz-Drost

Oppel

Grupp

et al. 2015

International Orthopaedics (SICOT)

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“…As a three dimensional reconstructed CT scan allows the diagnosis of fractures to sternum and concomitant fractures with high sensitivity the surgeon gets detailed information about the injury 28,29 . The CT shows the particular position and the direction of the fracture as well as any dislocation.…”

Section: Discussionmentioning

confidence: 99%

Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling

Schulz-Drost

Oppel

Grupp

et al. 2015

JoVE

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Different ways to stabilize a sternal fracture are described in literature. Respecting different mechanisms of trauma such as the direct impact to the anterior chest wall or the flexion-compression injury of the trunk, there is a need to retain each sternal fragment in the correct position while neutralizing shearing forces to the sternum. Anterior sternal plating provides the best stability and is therefore increasingly used in most cases. However, many surgeons are reluctant to perform sternal osteosynthesis due to possible complications such as difficulties in preoperative planning, severe injuries to mediastinal organs, or failure of the performed method.This manuscript describes one possible safe way to stabilize different types of sternal fractures in a step by step guidance for anterior sternal plating using low profile locking titanium plates. Before surgical treatment, a detailed survey of the patient and a three dimensional reconstructed computed tomography is taken out to get detailed information of the fracture's morphology. The surgical approach is usually a midline incision. Its position can be described by measuring the distance from upper sternal edge to the fracture and its length can be approximated by the summation of 60 mm for the basis incision, the thickness of presternal soft tissue and the greatest distance between the fragments in case of multiple fractures.Performing subperiosteal dissection along the sternum while reducing the fracture, using depth limited drilling, and fixing the plates prevents injuries to mediastinal organs and vessels.Transverse fractures and oblique fractures at the corpus sterni are plated longitudinally, whereas oblique fractures of manubrium, sternocostal separation and any longitudinally fracture needs to be stabilized by a transverse plate from rib to sternum to rib. Usually the high convenience of a patient is seen during follow up as well as a precise reconstruction of the sternal morphology.

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The Utility of 3-D CT Scan in the Diagnosis and Evaluation of Sternal Fractures

Cited by 19 publications

References 3 publications

Sternal Fracture in Children: Diagnosis by Ultrasonography

Sternal Fracture in Children: Diagnosis by Ultrasonography

The oblique fracture of the manubrium sterni caused by a seatbelt—a rare injury? Treatment options based on the experiences gained in a level I trauma centre

Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling

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