Surgical treatment of sternal fracture

doi:10.3877/cma.j.issn.2095-8773.2023.02.04

Abstract

Abstract:

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.

Key words: Sternal fracture, Surgery, Internal fixation

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

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References 36

1	Harston A，Roberts C．Fixation of sternal fractures：a systematic review[J]．J Trauma，2011，71（6）：1875-1879．
2	Brookes JG，Dunn RJ，Rogers IR．Sternal fractures：a retrospective analysis of 272 cases[J]．J Trauma，1993，35（1）：46-54．
3	Krinner S，Grupp S，Oppel 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 Dis，2017，9（4）：1054-1064．
4	Zhao Y，Yang Y，Gao Z，et al．Treatment of traumatic sternal fractures with titanium plate internal fixation：a retrospective study[J]．J Cardiothorac Surg，2017，12（1）：22．
5	Klei DS，de Jong MB，Öner FC，et al．Current treatment and outcomes of traumatic sternal fractures-a systematic review[J]．Int Orthop，2019，43（6）：1455-1464．
6	Ahmad K，Katballe N，Pilegaard H．Fixation of sternal fracture using absorbable plating system，three years follow-up[J]．J Thorac Dis，2015，7（5）：E131-E134．
7	Knobloch K，Wagner S，Haasper 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 Surg，2006，82（2）：444-450．
8	Scheyerer MJ，Zimmermann SM，Bouaicha S，et al．Location of sternal fractures as a possible marker for associated injuries[J]．Emerg Med Int，2013，2013：407589．
9	Schulz-Drost S，Oppel P，Grupp 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 Orthop，2016，40（4）：791-798．
10	Divisi D，Crisci R．Use of demineralized bone matrix and plate for sternal stabilization after traumatic dislocation[J]．Gen Thorac Cardiovasc Surg，2011，59（1）：52-56．
11	Byun CS，Park IH，Hwang WJ，et al．Analysis of Sternal Fixation Results According to Plate Type in Sternal Fracture[J]．Korean J Thorac Cardiovasc Surg，2016，49（5）：361-365．
12	Kälicke T，Frangen TM，Müller EJ，et al．Traumatic manubriosternal dislocation[J]．Arch Orthop Trauma Surg，2006，126（6）：411-416．
13	Yakar S，Baykan N，Önal Ö，et al．Retrospective analysis of patients with sternal fracture[J]．Turk J Emerg Med，2021，21（1）：20-23．
14	Compston JE，McClung MR，Leslie WD．Osteoporosis[J]．Lancet，2019，393（10169）：364-376．
15	van de Wall BJM，Beeres FJP，Link B，et al．Inter- and intra-observer variability of the AO/OTA classification for sternal fractures：a validation study[J]．Arch Orthop Trauma Surg，2020，140（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，2008，10（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 K，Gakidis J，Mihos P，et al．Management of sternal fractures：239 cases[J]．Asian Cardiovasc Thorac Ann，2002，10（2）：145-149．
19	Racine S，Drake D．BET 3：Bedside ultrasound for the diagnosis of sternal fracture[J]．Emerg Med J，2015，32（12）：971-972．
20	Du MJ，Lin YH，Chen WT，et al．Advances in the application of ultrasound for fracture diagnosis and treatment[J]．Eur Rev Med Pharmacol Sci，2022，26（21）：7949-7954．
21	Al-Qudah A．Operative treatment of sternal fractures[J]．Asian Cardiovasc Thorac Ann，2006，14（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），2010，31（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，2019，6（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），2021，14（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，2017，2（16）：104-105．
26	Ciriaco P，Casiraghi M，Negri G，et al．Early surgical repair of isolated traumatic sternal fractures using a cervical plate system[J]．J Trauma，2009，66（2）：462-464．
27	Molina JE．Evaluation and operative technique to repair isolated sternal fractures[J]．J Thorac Cardiovasc Surg，2005，130（2）：445-448．
28	Schulz-Drost S，Oppel P，Grupp 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 Exp，2015，（95）：e52124．
29	Ruedi TP，Murphy WM. AO principles of fracture management [M].New York：Thieme Medical Publishers，2001：137-142.
30	Rothberg DL，Lee MA．Internal fixation of osteoporotic fractures[J]．Curr Osteoporos Rep，2015，13（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，2016，16（71）：61.
32	Xie ZX，Zhou XT，Zhang DS，et al．Minimally invasive plate osteosynthesis for the treatment of sternal fracture in the lower chest：a case report[J]．J Int Med Res，2019，47（8）：4033-4038．
33	Imanishi N，Takeda Y，Ichiki Y，et al．Thoracoscopy-assisted repair of comminuted sternal fracture with bioresorbable plates[J]．Interact Cardiovasc Thorac Surg，2019，29（3）：478-480．
34	Fang C，Cai L，Chu G，et al．3D printing in fracture treatment：Current practice and best practice consensus[J]．Unfallchirurgie （Heidelb），2022，125（Suppl 1）：1-7．
35	Yammine K，Karbala J，Maalouf 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 Surg，2022，48（5）：3479-3491．
36	Xiong L，Li X，Li H，et al．The efficacy of 3D printing-assisted surgery for traumatic fracture：a meta-analysis[J]．Postgrad Med J，2019，95（1126）：414-419．

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