Korean J Thorac Cardiovasc Surg.  2016 Oct;49(5):361-365. 10.5090/kjtcs.2016.49.5.361.

Analysis of Sternal Fixation Results According to Plate Type in Sternal Fracture

• Byun CS
• Park IH
• Hwang WJ
• Lee Y
• Cho HM

• KMID: 2354370
• DOI: http://doi.org/10.5090/kjtcs.2016.49.5.361

Abstract

BACKGROUND
Sternal fractures are relatively rare, and caused mainly by blunt anterior chest wall trauma. In most cases, sternal fractures are treated conservatively. However, if the patient exhibits problematic symptoms such as intractable chest wall pain or bony crepitus due to sternal instability, surgical correction is indicated. But no consensus exists regarding the most appropriate surgical method. We analyzed the results of surgical fixation in cases of sternal fracture in order to identify which surgical method led to the best outcomes.
METHODS
We retrospectively reviewed the medical records of patients with sternal fractures from December 2008 to December 2011, and found 19 patients who underwent open reduction and internal fixation of the sternum with a longitudinal plate (L-group) or a T-shaped plate (T-group). We investigated patients' characteristics, clinical details regarding each case of chest trauma, the presence of other associated injuries, the type of open reduction and fixation, whether a combined operation was performed, and postoperative complications.
RESULTS
Of the 19 patients, 10 patients (52.6%) were male, and their average age was 56.8 years (range, 32 to 82 years). Seven patients (36.8%) had isolated sternal fractures, while 12 (63.2%) had other associated injuries. Seven patients (36.8%) were in the L-group and 12 patients (63.2%) were in the T-group. Three patients in the L-group (42.9%) showed a loosening of the fixation. In all patients in the T-group, the fracture exhibited stable alignment.
CONCLUSION
Open reduction and internal fixation with a T-shaped plate in sternal fractures is a safer and more efficient treatment method than treatment with a longitudinal plate, especially in patients with a severely displaced sternum or anterior flail chest, than a longitudinal plate.

Keyword

Sternum; Thoracic injuries; Fracture fixation; Bone plates

MeSH Terms

Bone Plates
Consensus
Flail Chest
Fracture Fixation
Humans
Male
Medical Records
Methods
Postoperative Complications
Retrospective Studies
Sensitivity Training Groups
Sternum
Thoracic Injuries
Thoracic Wall
Thorax