Management of Sternal Segment Dislocation in a Child with Closed Reduction

Abstract

Trauma may lead to sternal fracture or dislocation. Dislocation of a sternal segment in the childhood period is very rare as for sternal fractures in children. There are only six case reports regarding the issue in the literature. Additionally, there is not an established consensus for the treatment of the pathology. In this paper we present traumatic dislocation of a sternal body segment in a 10-year-old child who was successfully managed conservatively by closed reduction together with the review of the literature. Surgical treatment is not necessary especially in acute cases. Pathology may be treated with closed reduction. Callus formation usually supports the dislocated part of the sternum in time.

Right Ventricular Epicardial Fibrosis in Mice With Sternal Segment Dislocation

“…8 Callus formation following sternal fracture/dislocation has also been documented in humans. 23 A case of severe extrinsic pulmonic stenosis due to sternal callus was reported in 1 patient. 22 This is not surprising as the sternocostal boundary of the heart in humans predominantly consists of the free surface of the right ventricle.…”

“…18,30 It is an extremely rare pathology in humans and mostly reported in children. 23,31 The sternum is less susceptible to fracture in children since the sternum and associated structures are more elastic and the ribs are more flexible than in adults. 31 Further, the sternebrae in early childhood are joined by primary cartilaginous joints (synchrondrosis) while they are fused by synostosis in adulthood.…”

Sternal fracture in growing children

“…Bei der Literatursuche trifft man seit den 60er Jahren auf einzelne Fallberichte [10,13,14,15,19,20,21]. Unrein [22] beobachtete bei 364 Kindern mit stumpfen Thoraxtrauma in 21 Jahren lediglich 6 Sternumfrakturen (0,007%).…”

“…In der Literatur sind lediglich eine operative Kirschner-Draht-Fixierung der Frakturfragmente bei persistierenden Schmerzen am Sternum beschrieben [15] sowie eine geschlossene Reposition bei dislozierten Fraktur [20]. …”

“…Unkomplizierte Frakturen am kindlichen Sternum führen relativ rasch zur Beschwerdefreiheit [4,10,14], sodass eine symptomatische Therapie ausreichend ist. In der Literatur wird in den letzten Jahrzehnten lediglich von einer operativen Fragmentfixation mit K-Drähten bei persistierenden Schmerzen berichtet [15] sowie einer geschlossenen Reposition ohne weitere Redression [20].…”