切换至 "中华医学电子期刊资源库"

中华胸部外科电子杂志 ›› 2023, Vol. 10 ›› Issue (02) : 80 -85. doi: 10.3877/cma.j.issn.2095-8773.2023.02.04

胸壁创伤和畸形矫治专题

胸骨骨折的外科治疗
张强(), 李博闻, 刘振振   
  1. 100035 北京,北京积水潭医院胸外科
  • 收稿日期:2023-01-03 修回日期:2023-03-29 接受日期:2023-05-15 出版日期:2023-05-28
  • 通信作者: 张强

Surgical treatment of sternal fracture

Qiang Zhang(), Bowen Li, Zhenzhen Liu   

  1. Department of Thoracic Surgery, Beijing Jishuitan Hospital, Beijing 100035, China
  • Received:2023-01-03 Revised:2023-03-29 Accepted:2023-05-15 Published:2023-05-28
  • Corresponding author: Qiang Zhang
引用本文:

张强, 李博闻, 刘振振. 胸骨骨折的外科治疗[J]. 中华胸部外科电子杂志, 2023, 10(02): 80-85.

Qiang Zhang, Bowen Li, Zhenzhen Liu. Surgical treatment of sternal fracture[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2023, 10(02): 80-85.

胸骨骨折是一种较为少见的骨折类型,其在所有类型的骨折中发病率不足0.5%。但是近年来,随着工业化与交通工具的发展,其发病率呈上升趋势。目前对于其治疗方案尚未达成共识,胸骨骨折的手术治疗和非手术治疗仍存在争议,而手术治疗的方式、材料的选择等也因人而异。合理把握手术指征、选择合适手术方式和内固定材料可促进患者快速康复,明显改善预后。本文对胸骨骨折的相关流行病学、发病机制及临床表现方面给予相应介绍,并对目前外科治疗胸骨骨折的方法及相关研究进展进行综述。

Sternal fracture is a relatively rare type of fracture, and its incidence rate is less than 0.5% in all types of fractures. However, in recent years, the incidence of sternal fracture is on the rise with the development of industrialization and transportation. At present, no consensus has been reached on its treatment regime, and the surgical and non-surgical treatments of sternal fracture are still controversial, while the surgical treatment modalities, the choice of materials, and so on vary among individuals. Reasonable grasp of surgical indications, selection of appropriate surgical methods and internal fixation materials can promote the rapid recovery of patients and significantly improve the prognosis. In this review, we give an update on the relevant epidemiology, pathogenesis, and clinical manifestations of sternal fracture and provide an overview of the current surgical treatment and the related research progress of sternal fracture.

图1 胸骨骨折分型
1
Harston ARoberts C.Fixation of sternal fractures:a systematic review[J].J Trauma201171(6):1875-1879.
2
Brookes JGDunn RJRogers IR.Sternal fractures:a retrospective analysis of 272 cases[J].J Trauma199335(1):46-54.
3
Krinner SGrupp SOppel P,et al.Do low profile implants provide reliable stability in fixing the sternal fractures as a "fourth vertebral column" in sternovertebral injuries?[J].J Thorac Dis20179(4):1054-1064.
4
Zhao YYang YGao Z,et al.Treatment of traumatic sternal fractures with titanium plate internal fixation:a retrospective study[J].J Cardiothorac Surg201712(1):22.
5
Klei DSde Jong MBÖner FC,et al.Current treatment and outcomes of traumatic sternal fractures-a systematic review[J].Int Orthop201943(6):1455-1464.
6
Ahmad KKatballe NPilegaard H.Fixation of sternal fracture using absorbable plating system,three years follow-up[J].J Thorac Dis20157(5):E131-E134.
7
Knobloch KWagner SHaasper C,et al.Sternal fractures occur most often in old cars to seat-belted drivers without any airbag often with concomitant spinal injuries:clinical findings and technical collision variables among 42,055 crash victims[J].Ann Thorac Surg200682(2):444-450.
8
Scheyerer MJZimmermann SMBouaicha S,et al.Location of sternal fractures as a possible marker for associated injuries[J].Emerg Med Int20132013:407589.
9
Schulz-Drost SOppel PGrupp S,et al.The oblique fracture of the manubrium sterni caused by a seatbelt--a rare injury? Treatment options based on the experiences gained in a level I trauma centre[J].Int Orthop201640(4):791-798.
10
Divisi DCrisci R.Use of demineralized bone matrix and plate for sternal stabilization after traumatic dislocation[J].Gen Thorac Cardiovasc Surg201159(1):52-56.
11
Byun CSPark IHHwang WJ,et al.Analysis of Sternal Fixation Results According to Plate Type in Sternal Fracture[J].Korean J Thorac Cardiovasc Surg201649(5):361-365.
12
Kälicke TFrangen TMMüller EJ,et al.Traumatic manubriosternal dislocation[J].Arch Orthop Trauma Surg2006126(6):411-416.
13
Yakar SBaykan NÖnal Ö,et al.Retrospective analysis of patients with sternal fracture[J].Turk J Emerg Med202121(1):20-23.
14
Compston JEMcClung MRLeslie WD.Osteoporosis[J].Lancet2019393(10169):364-376.
15
van de Wall BJMBeeres FJPLink B,et al.Inter- and intra-observer variability of the AO/OTA classification for sternal fractures:a validation study[J].Arch Orthop Trauma Surg2020140(6):735-739.
16
张强,王彦彬,宋磊.锁定加压钢板在胸骨骨折手术中的应用[J].中华创伤骨科杂志200810(11):1099-1100.
17
苏志勇,吴骏.危重胸部创伤处理技术[M].北京:人民军医出版社,2014
18
Potaris KGakidis JMihos P,et al.Management of sternal fractures:239 cases[J].Asian Cardiovasc Thorac Ann200210(2):145-149.
19
Racine SDrake D.BET 3:Bedside ultrasound for the diagnosis of sternal fracture[J].Emerg Med J201532(12):971-972.
20
Du MJLin YHChen WT,et al.Advances in the application of ultrasound for fracture diagnosis and treatment[J].Eur Rev Med Pharmacol Sci202226(21):7949-7954.
21
Al-Qudah A.Operative treatment of sternal fractures[J].Asian Cardiovasc Thorac Ann200614(5):399-401.
22
阮征,郑健,王邵华,等.创伤性胸骨骨折43例临床诊治[J].同济大学学报(医学版)201031(6):94-97.
23
张景晖.Nuss手术治疗多发性肋骨骨折和胸骨骨折1例[J].中华胸部外科电子杂志20196(1):35-36.
24
浙江省医学会创伤医学分会胸部创伤学组,肋骨胸骨创伤诊治:浙江省胸外科专家共识(2021版)编审委员会.肋骨胸骨创伤诊治:浙江省胸外科专家共识(2021版)[J].中华危重症医学杂志(电子版)202114(2):89-99.
25
闫斐,郭洪诊.胸骨骨折合并多发肋骨骨折治疗体会[J].实用临床护理学电子杂志20172(16):104-105.
26
Ciriaco PCasiraghi MNegri G,et al.Early surgical repair of isolated traumatic sternal fractures using a cervical plate system[J].J Trauma200966(2):462-464.
27
Molina JE.Evaluation and operative technique to repair isolated sternal fractures[J].J Thorac Cardiovasc Surg2005130(2):445-448.
28
Schulz-Drost SOppel PGrupp S,et al.Surgical fixation of sternal fractures:preoperative planning and a safe surgical technique using locked titanium plates and depth limited drilling[J].J Vis Exp2015,(95):e52124.
29
Ruedi TPMurphy WM. AO principles of fracture management [M].New York:Thieme Medical Publishers,2001:137-142.
30
Rothberg DLLee MA.Internal fixation of osteoporotic fractures[J].Curr Osteoporos Rep201513(1):16-21.
31
刘晓军,李营. 创伤性胸骨骨折的外科治疗效果观察与分析[J].世界最新医学信息文摘201616(71):61.
32
Xie ZXZhou XTZhang DS,et al.Minimally invasive plate osteosynthesis for the treatment of sternal fracture in the lower chest:a case report[J].J Int Med Res201947(8):4033-4038.
33
Imanishi NTakeda YIchiki Y,et al.Thoracoscopy-assisted repair of comminuted sternal fracture with bioresorbable plates[J].Interact Cardiovasc Thorac Surg201929(3):478-480.
34
Fang CCai LChu G,et al.3D printing in fracture treatment:Current practice and best practice consensus[J].Unfallchirurgie (Heidelb)2022125(Suppl 1):1-7.
35
Yammine KKarbala JMaalouf A,et al.Clinical outcomes of the use of 3D printing models in fracture management:a meta-analysis of randomized studies[J].Eur J Trauma Emerg Surg202248(5):3479-3491.
36
Xiong LLi XLi H,et al.The efficacy of 3D printing-assisted surgery for traumatic fracture:a meta-analysis[J].Postgrad Med J201995(1126):414-419.
[1] 李辉, 吴奇, 张子琦, 张晗, 王仿, 许鹏. 日间全膝关节置换术早期疗效及标准化流程探索[J]. 中华关节外科杂志(电子版), 2023, 17(06): 889-892.
[2] 代莉, 邓恢伟, 郭华静, 黄芙蓉. 术中持续输注艾司氯胺酮对腹腔镜结直肠癌手术患者术后睡眠质量的影响[J]. 中华普通外科学文献(电子版), 2023, 17(06): 408-412.
[3] 杨倩, 李翠芳, 张婉秋. 原发性肝癌自发性破裂出血急诊TACE术后的近远期预后及影响因素分析[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 33-36.
[4] 李建美, 邓静娟, 杨倩. 两种术式联合治疗肝癌合并肝硬化门静脉高压的安全性及随访评价[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 41-44.
[5] 逄世江, 黄艳艳, 朱冠烈. 改良π形吻合在腹腔镜全胃切除消化道重建中的安全性和有效性研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 66-69.
[6] 杨体飞, 杨传虎, 陆振如. 改良无充气经腋窝入路全腔镜下甲状腺手术对喉返神经功能的影响研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 74-77.
[7] 陈旭渊, 罗仕云, 李文忠, 李毅. 腺源性肛瘘经手术治疗后创面愈合困难的危险因素分析[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 82-85.
[8] 纪凯伦, 郝少龙, 孙海涛, 韩威. 减重术后胆囊结石形成机制的新进展[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 100-103.
[9] 陈航, 闵翔. 日间甲状腺切除术后出血的12例临床分析及应对措施[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 600-602.
[10] 罗佳, 赵晶晶, 曹小珍, 钟玲, 范林军, 曾令娟. 单侧腋窝双侧乳晕入路机器人甲状腺术后局部加压预防皮下隧道出血的对照研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 603-606.
[11] 陈垚, 徐伯群, 高志慧. 改良式中间上入路根治术治疗甲状腺癌的有效性安全性研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 619-622.
[12] 夏松, 姚嗣会, 汪勇刚. 经腹腹膜前与疝环充填式疝修补术治疗腹股沟疝的对照研究[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 702-705.
[13] 程相阵. 腹茧症9例诊治分析并文献复习[J]. 中华临床医师杂志(电子版), 2023, 17(9): 968-971.
[14] 李静, 张玲玲, 邢伟. 兴趣诱导理念用于小儿手术麻醉诱导前的价值及其对家属满意度的影响[J]. 中华临床医师杂志(电子版), 2023, 17(07): 812-817.
[15] 李莹倩, 李华山. 基于真实世界的完全性直肠脱垂治疗方式评价[J]. 中华临床医师杂志(电子版), 2023, 17(06): 700-705.
阅读次数
全文


摘要