脊椎骨折と胸骨骨折を合併した症例（sternovertebral fracture）の治療成績(Outcomes of patients with vertebral and sternum fractures (sternovertebral fractures))

Abstract

Sternovertebral fractures, which are simultaneous fractures of the spine and sternum, usually result to body trunk instability. This study aimed at investigating the characteristics, treatment strategies, and outcomes of sternovertebral fractures. Methods: We included 27 cases of sternovertebral fractures diagnosed between 2008 and 2020. The variables investigated were the fracture sites, treatment methods, type of bone union, and complaints. Results: Sternal fractures concerned the sternal body (22 cases), manubrium (3 cases), and both segments (2 cases). Nine patients had displaced sternal fractures. The spine fractures involved the cervical (2 cases), thoracic (17 cases), and lumbar (4 cases) segments, and there were four cases of multiple-level spine fractures. Types I, II, and III column injuries (Denis classification) were identified in 4, 13, and 10 cases, respectively. Complications included multiple rib fractures [12 cases (44%)], hemopneumothorax [7 cases (26%)], and lung contusion [6 cases (22%)]. There were no cases of cardiac or aortic injuries. The sternal fractures were treated conservatively in almost all the cases [26/27 cases (96%)]. Spinal fractures were treated surgically in 17 cases (63%). A satisfactory bone union was obtained in all the cases of sternal and spinal fractures, and complaints were noted in 2/27 (7%) sternal fractures and 14/27 (52%) spinal fractures. Conclusion:The most frequent clinical form of sternovertebral fractures was combined sternal body/thoracic spine fracture. In sternovertebral fractures, sternal fractures are mostly treated by conservative means.