- A decade of treating traumatic sternal fractures in a single-center experience in Korea: a retrospective cohort study
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Na Hyeon Lee, Seon Hee Kim, Jae Hun Kim, Ho Hyun Kim, Sang Bong Lee, Chan Ik Park, Gil Hwan Kim, Dong Yeon Ryu, Sun Hyun Kim
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J Trauma Inj. 2023;36(4):362-368. Published online November 30, 2023
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DOI: https://doi.org/10.20408/jti.2023.0027
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- Purpose
Clinical reports on treatment outcomes of sternal fractures are lacking. This study details the clinical features, treatment approaches, and outcomes related to traumatic sternal fractures over a 10-year period at a single institution.
Methods
A retrospective cohort study was conducted of patients admitted to a regional trauma center between January 2012 and December 2021. Among 7,918 patients with chest injuries, 266 were diagnosed with traumatic sternal fractures. Patient data were collected, including demographics, injury mechanisms, severity, associated injuries, sternal fracture characteristics, hospital stay duration, mortality, respiratory complications, and surgical details. Surgical indications encompassed emergency cases involving intrathoracic injuries, unstable fractures, severe dislocations, flail chest, malunion, and persistent high-grade pain.
Results
Of 266 patients with traumatic sternal fractures, 260 were included; 98 underwent surgical treatment for sternal fractures, while 162 were managed conservatively. Surgical indications ranged from intrathoracic organ or blood vessel injuries necessitating thoracotomy to unstable fractures with severe dislocations. Factors influencing surgical treatment included flail motion and rib fracture. The median length of intensive care unit stay was 5.4 days (interquartile range [IQR], 1.5–18.0 days) for the nonsurgery group and 8.6 days (IQR, 3.3–23.6 days) for the surgery group. The median length of hospital stay was 20.9 days (IQR, 9.3–48.3 days) for the nonsurgery group and 27.5 days (IQR, 17.0 to 58.0 days) for the surgery group. The between-group differences were not statistically significant. Surgical interventions were successful, with stable bone union and minimal complications. Flail motion in the presence of rib fracture was a crucial consideration for surgical intervention.
Conclusions
Surgical treatment recommendations for sternal fractures vary based on flail chest presence, displacement degree, and rib fracture. Surgery is recommended for patients with offset-type sternal fractures with rib and segmental sternal fractures. Surgical intervention led to stable bone union and minimal complications.
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Summary
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Citations
Citations to this article as recorded by  - Sternal fracture management
Bracken A. Armstrong, Steven M. Lorch, Jose J. Diaz
Current Problems in Surgery.2025; 64: 101725. CrossRef - Monitoring and Outcomes of Central Line-Associated Bloodstream Infections in a Tertiary Care Intensive Care Unit
Peter B Kharduit, Kaustuv Dutta, Clarissa J Lyngdoh, Prithwis Bhattacharyya, Valarie Lyngdoh, Annie B Khyriem, Suriya K Devi
Cureus.2024;[Epub] CrossRef
- Iatrogenic Delayed Aortic Injury Following a Surgical Stabilization of Flail Chest
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Junepill Seok, Hyun Min Cho, Seon Hee Kim, Ho Hyun Kim
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J Trauma Inj. 2018;31(3):174-176. Published online December 31, 2018
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DOI: https://doi.org/10.20408/jti.2018.037
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3,563
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Most of aortic injuries after blunt chest trauma usually occur at the aortic isthmus and are identified in the emergency department soon after arrival. Delayed aortic injures by fractured posterior ribs, however, are relatively rare and have been reported only a few times. We recently experienced an iatrogenic descending aortic injury sustained as a result of a direct puncture by a sharp rib end after surgical stabilization of rib fractures. -
Summary
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Citations
Citations to this article as recorded by - Surgical Stabilisation of Traumatic Rib Fractures with Chronic, Residual Type A Aortic Dissection
Kieran J. Matic, Rajkumar Cheluvappa, Selwyn Selvendran
Healthcare.2021; 9(4): 392. CrossRef
- Rectus Sheath Hematoma Caused by Noncontact Strenuous Exercise
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Gil Hwan Kim, Jae Hun Kim, Ho Hyun Kim
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J Trauma Inj. 2017;30(4):227-230. Published online December 30, 2017
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DOI: https://doi.org/10.20408/jti.2017.30.4.227
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Rectus sheath hematoma (RSH) is an uncommon but well-documented clinical condition. It is usually caused by direct trauma or anticoagulation, although there are many other causes. However, RSH after noncontact strenuous exercise is very rare. We present a rare case of RSH after playing volleyball without direct trauma that was successfully treated by angiographic embolization. -
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