![]() The sternum has different fracture types, depending on the injury mechanism since direct blunt trauma, indirect impact, and forced traction of muscles can cause sternal fractures ( 1). Scheyerer mentioned the relevance of the fracture localization in the sternum and underlined that especially fractures of the manubrium have a special clinical relevance for the stability and additionally indicate a higher risk for concomitant injuries ( 7). ![]() These percentages demonstrate that the sternum plays a key role for the stability of the thoracic cage. The number is even higher in multiple trauma patients (3.9% isolated sternum fractures) in combination with other rib fractures (7.8–11.2%) and in flail chest injuries (10.8–21.2%) ( 6). Accepted for publication Jan 11, 2018.įrom the end of the 19th century up to the mid of the 20th century, fractures of the sternum were mentioned with an incidence of under 1% and increased with the number of car accidents to 5–8% of all bone injuries ( 1- 6). ![]() Keywords: Sternum fracture manubrium fracture classification sternal fracture anterior chest wall Level of evidence: Level III retrospective prognostic cohort study To treat complex C-type fractures, plates with a T- or H-form could be a good solution. A-type fractures were stabilized with a longitudinal plate osteosynthesis and B-type fractures with transverse positioned plates. Fractures only little dislocation were treated conservatively, and unstable fractures were surgically stabilized (n=10).Ĭonclusions: In summary, three main types of fractures could be found. Fractures of the manubrium appeared in following types: A-type-transverse fracture (n=11) in 1st intercostal space by direct blunt trauma or flexion of the torso with sagittal instability B-type-oblique fracture (n=9) by seat belt injury with rotatory instability C-type-combined, more fragmentary fracture (n=3) by direct blunt trauma with simultaneous flexion of the torso and multi directional instability. Results: Of 890 evaluable patients, 154 (17.3%) had a fracture of the sternum and 23 (2.6%) of the manubrium. Fracture type, collateral injuries, age, and information about the circumstances of the accident were noted. Methods: Between January 2012 and October 2014, data was collected from all severely injured patients (ISS ≥16), which received a CT scan of the thorax in our Level-I-Trauma Center and retrospectively analyzed concerning sternal fractures. This study reports on different types of fractures which involve the manubrium sterni. Therefore the questions arise what types of fractures are observed in today’s clinical practice, how to classify them and which treatment options are available. In addition, in its function as a capstone in between the anterior chest wall and the shoulder girdle, it is exposed to a multiplicity of forces. Fractures of the sternal manubrium are, however, more frequently associated with severe concomitant injuries of thoracic organs, and therefore deserve special attention. ![]() ![]() Interviews with Outstanding Guest Editorsīackground: Sternum fractures are mostly located on the sternal corpus, seldom on the manubrium.Policy of Dealing with Allegations of Research Misconduct.Policy of Screening for Plagiarism Process. ![]()
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