Surgical Management of Traumatic Manubrio-Sternal Dislocation With Locking Compression Plate; A Case Report and Review of Literature.

Abstract

Background: Manubriosternal joint dislocation as a result of trauma is rare with only few case reports published in the literature. Materials that have been used for fixation of displaced manubriosternal joint are steel wires, polydioxanone ropes, and plates with screws. Case: We present a case of manubriosternal dislocation in which fixation was done with locking compression plate. It is a case of 32-years-old lady with a history of road traffic accident; car ran over her chest. She had multiple bilateral rib fractures and manubriosternal joint dislocation of type-I. The patient was initially stabilised in high dependency unit, and once her contusions got better, she underwent fixation of her manubriosternal dislocation with locking compression plate. Post-operatively she remained pain-free and was discharged home. Conclusion: This case is an important addition to literature regarding options that can be used for fixation of manubriosternal joint dislocation.

Manubriosternal dislocation type II associated with thoracic spine fracture: What can we learn from this?

“…[4] Manubriosternal dislocations are a rare occurrence, representing 17.6% of lesions of the sternum, corresponding to <0.5% of all traumatic lesions. [1][2][3]5] Of 250 fatal road accidents, this type of lesion was observed in 13 patients, and was associated with fracture of the thoracic spine in just 3 individuals. [2] Fowler et al [6] reported 21 patients with dislocation fractures of the sternum, in 9 of whom fractures of the thoracic vertebrae were diagnosed.…”

“…Various operative procedures using plates, wire loops, Kirschner wires or polydioxanone loops have been described in the literature. [1,22] Schmitz et al [23] report a resection arthroplasty for luxation of the manubriosternal joint in rheumatoid arthritis, with success. The excision of a manubriosternal synchondrosis already damaged by a traumatic event, and the cuneiform chondrectomy of the third and fourth rib cartilage bilaterally, was the technique used by Divisi et al, [24] with an acceptable outcome.…”

“…There are very few published case reports. [1][2][3] There is no definite standard for treating such injuries, and in practice, the thoracic surgeon often has difficulty choosing and planning surgical technique(s). We describe a case of a young woman with traumatic manubriosternal dislocation.…”