Stefan Schulz-Drost1,2, Pascal Oppel3, Sina Grupp3, Dominic Taylor4, Sebastian Krinner3, Andreas Langenbach3, Friedrich Hennig3, Andreas Mauerer4. 1. Department of Orthopaedic and Trauma Surgery, University Hospital Erlangen, Erlangen, Germany. stefan.schulz-drost@uk-erlangen.de. 2. Department of Pediatric Surgery, University Hospital Erlangen, Erlangen, Germany. stefan.schulz-drost@uk-erlangen.de. 3. Department of Orthopaedic and Trauma Surgery, University Hospital Erlangen, Erlangen, Germany. 4. Department of Orthopaedic and Trauma Surgery, St. Theresien Krankenhaus, Nürnberg, Germany.
Abstract
INTRODUCTION: Sternal fractures are rare with 3-8 % out of the total number of trauma cases mostly caused by direct impact to the anterior chest wall. Most cases described are due to motor vehicle crash either caused by direct impact to the steering wheel or by the seat belt. Fractures mainly occur to the sternal body. Only rarely are cases of manubrium fractures described in literature, for example, in relationship with a direct impact to the shoulder which caused an oblique fracture near to the sternoclavicular joint. Three patients with profoundly dislocated oblique manubrium fracture were admitted to our Level I Trauma Center in 2012 and 2013. Those patients suffered from instability of the upper sternum and the shoulder girdle. MATERIAL AND METHODS: Between January 2012 and October 2013, a total of 538 trauma patients were admitted to the emergency room and received whole body CT-scan. They were analysed retrospectively for sternal fractures. In cases of instability and dislocation, fracture stabilisation was performed by anterior plating through a medial approach using low profile titanium plates (MatrixRib®). RESULTS: Seventy-nine (14.7 %) patients showed sternal fracture, out of which 13 (2.4 %) patients showed a fracture of manubrium, ten caused by seatbelt. In three cases stabilization was performed. Follow up showed sufficient consolidation without complications. DISCUSSION: A total of 16.5 % of sternal fractures were localized at the manubrium, mostly caused by seat belt. Fractures without significant dislocation seemed to be stable and healed well under conservative treatment. Dislocation in this region leads to unstable shoulder girdle. Anterior plating provides sufficient stabilisation and allowed consolidation.
INTRODUCTION: Sternal fractures are rare with 3-8 % out of the total number of trauma cases mostly caused by direct impact to the anterior chest wall. Most cases described are due to motor vehicle crash either caused by direct impact to the steering wheel or by the seat belt. Fractures mainly occur to the sternal body. Only rarely are cases of manubrium fractures described in literature, for example, in relationship with a direct impact to the shoulder which caused an oblique fracture near to the sternoclavicular joint. Three patients with profoundly dislocated oblique manubrium fracture were admitted to our Level I Trauma Center in 2012 and 2013. Those patients suffered from instability of the upper sternum and the shoulder girdle. MATERIAL AND METHODS: Between January 2012 and October 2013, a total of 538 traumapatients were admitted to the emergency room and received whole body CT-scan. They were analysed retrospectively for sternal fractures. In cases of instability and dislocation, fracture stabilisation was performed by anterior plating through a medial approach using low profile titanium plates (MatrixRib®). RESULTS: Seventy-nine (14.7 %) patients showed sternal fracture, out of which 13 (2.4 %) patients showed a fracture of manubrium, ten caused by seatbelt. In three cases stabilization was performed. Follow up showed sufficient consolidation without complications. DISCUSSION: A total of 16.5 % of sternal fractures were localized at the manubrium, mostly caused by seat belt. Fractures without significant dislocation seemed to be stable and healed well under conservative treatment. Dislocation in this region leads to unstable shoulder girdle. Anterior plating provides sufficient stabilisation and allowed consolidation.
Authors: Karsten Knobloch; Sebastian Wagner; Carl Haasper; Christian Probst; Christian Krettek; Dietmar Otte; Martinus Richter Journal: Ann Thorac Surg Date: 2006-08 Impact factor: 4.330
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Authors: Max J Scheyerer; Stefan M Zimmermann; Samy Bouaicha; Hans-Peter Simmen; Guido A Wanner; Clément M L Werner Journal: Emerg Med Int Date: 2013-11-13 Impact factor: 1.112
Authors: Stefan Schulz-Drost; Sebastian Krinner; Pascal Oppel; Sina Grupp; Melanie Schulz-Drost; Friedrich F Hennig; Andreas Langenbach Journal: J Thorac Dis Date: 2018-03 Impact factor: 2.895
Authors: Dorine S Klei; Mirjam B de Jong; F Cumhur Öner; Luke P H Leenen; Karlijn J P van Wessem Journal: Int Orthop Date: 2018-04-26 Impact factor: 3.075