Osteosynthesis of traumatic manubriosternal dislocations and sternal fractures with a 3.5/4.0 mm fixed-angle plate (LCP)

Abstract

Our positive experiences with the operative treatment using 3.5/4.0 mm fixed-angle plate (LCP) may help to establish the operative procedure of first choice in this group of patients.

Orthopaedic anatomy of the sternum: A micro-CT study to guide the fixation of sternal fractures

“…Rigid plate fixation has been shown to be an effective method of fixation of MSJ and other sternal fractures [2,7,10,11,13,14,19]. Ostensibly, the close proximity of vital organs directly abutting the dorsal surface of the sternum makes substantive bicortical constructs unfeasible.…”

“…A larger scale CT study of living patients with a normal age and equal gender distribution is warranted before areas of greatest screw purchase can be determined with certainty. In addition, the success of preliminary trials of rigid plate fixation for displaced MSJ and other sternal fractures show promise for development of an orthopedic standard for sternal fracture fixation [2,7,10,11,13,14,19].…”

“…In these studies, plating has been proven to provide lower rates of nonunion and mediastinitis, reduced pain, increased safety, closer sternal approximation, and required minimal soft tissue dissection as compared to cerclage wiring [2,11,12]. Additionally, preliminary studies of plate fixation of MSJ fracture-dislocations have shown low rates of complications and infection, excellent healing, and minimal damage to surrounding structures and vascular supply [10,13,14]. These studies along with the overwhelming success of rigid plate fixation in other orthopedic applications, place this method in the forefront for fixation of displaced MSJ fractures.…”

Surgical fixation of sternal fractures: locked plate fixation by low-profile titanium plates—surgical safety through depth limited drilling

“…In the following years, several methods such as intramedullary fixation, external fixator and conventional methods with wire cerclage and plate osteosynthesis have been described [16][17][18]. Currently published trials mostly describe sternal plating with locked implants such as LCP plates, special devices for sternal fractures such as the "TiFix" and the use of any other plate usually employed for internal fixation of long bones [8,19]. For example, use of plates for distal radius fractures was described by Ergene et al in 2012 [20].…”

“…There lies the reluctance of various surgical, and in particular, orthopaedic disciplines, to make any fixation of the chest [13]. Another aspect of the implants is sometimes their poor patient acceptance and/or soft tissue irritation [19].…”