Treatment of traumatic sternal fractures with titanium plate internal fixation: a retrospective study

Abstract

BackgroundThis study aim to evaluate surgical procedures for titanium plate internal fixation of sternal fractures with displacement or nonunion.MethodsFrom January 2010 to December 2014, 64 patients with sternal fractures were treated with titanium plate internal fixation in the thoracic surgery department of the Shanghai Sixth People’s Hospital. Pain severity scale scores were analyzed preoperatively and postoperatively. All the patients had a 2-month follow-up for treatment evaluation.ResultsThe mean hospital length of stay was 16.89 days. Forty-five patients underwent surgery for combined injuries. A statistically significant difference (P < 0.05) was found between preoperative and postoperative pain severity scores (7.74 ± 0.89 vs. 3.80 ± 0.79, respectively). At follow-up, healing of the nonunion or fracture was confirmed in all the cases.ConclusionThe rigid titanium plate application ensured a safe and easy management of traumatic sternal fractures and nonunion with a good prognosis as compared with other methods.

Current treatment and outcomes of traumatic sternal fractures—a systematic review

“…Sternal fractures are rare injuries with an incidence of less than 0.5% of all fractures and an estimated 3–8% in blunt trauma patients [ 1 – 4 ]. Traumatic sternal dislocations occur even less frequently [ 5 ].…”

“…Traumatic sternal dislocations occur even less frequently [ 5 ]. The most common mechanism of injury is direct blunt trauma to the anterior chest caused by motor vehicle accidents [ 1 , 6 – 8 ]. The incidence of sternal injury has increased since the introduction of seatbelt legislation [ 3 , 9 , 10 ].…”

“…The incidence of sternal injury has increased since the introduction of seatbelt legislation [ 3 , 9 , 10 ]. Additionally, sternal injuries are frequently caused by falls from height or indirect trauma due to spinal flexion-compression injury [ 1 , 2 , 5 , 6 , 11 ]. Traumatic sternal fractures are mostly transverse sternal body fractures, while manubrial and xiphoid fractures occur less frequently [ 3 , 8 , 10 ].…”

“…Other commonly associated injuries include brain injury and abdominal injury [ 3 , 9 ]. Concomitant injuries and severe chest pain could lead to respiratory insufficiency, organ failure, and ultimately mortality [ 1 , 2 ].…”

“…The majority of sternal fractures (> 95%) is treated conservatively [ 1 , 3 , 10 , 14 ]. Conservative treatment options consist of analgesia, corset fixation, rest, and passive reduction of displacement if necessary [ 1 , 15 ].…”