Surgical management of traumatic isolated sternal fracture and manubriosternal dislocation

Abstract

Therapeutic study, level IV; economic analysis, level IV.

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

“…Mayberry et al [14] identified three key points for intervention as follows: (1) the presence of a sternal deformity, (2) the loss of sternal continuity for a period exceeding 6 weeks, and (3) the persistence of chest pain (between 2 and 8 weeks, in the opinion of most surgeons surveyed). Divisi et al [13] stated that possible injury to the underlying vascular structures must also be considered. Steel wire fixation is widely used in longitudinal sternotomy but often fails in horizontal fractures and nonunion.…”

“…The steel wire sealing technique is suitable for longitudinal sternotomy, but most traumatic sternal fractures are transverse fractures or nonunions. In these cases, internal fixation with a titanium locking plate is a better choice [12, 13]. …”

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].…”

Isolated Sternal Fracture

“…However, the diagnosis may be challenging as it would not be visible on routine chest X-ray films. It may be divided into sternal fracture and sternal dislocation, accounting for 7.5% and 2.9% of chest trauma patients (1). ISFs are mostly benign, but a sustained chest pain should arouse the suspicion of such a lesion.…”