Characteristics of the Sternal Fractures and Associated Injuries: A Three-year Clinical Experience Sternal Fractures and Associated Injuries

Yıl 2019, Cilt: 11 Sayı: 3, 444 - 448, 23.10.2019

Emine Kadioglu Serhat Yalcinkaya

https://doi.org/10.18521/ktd.500053

Öz

Background

Although they constitute a small portion of thoracic
trauma, sternal fractures require attention as they may be indicators of major
cardiac injuries. The aim of this study is to review the diagnosis, treatment,
and outcome of such patients administered to our emergency department.

Material and Methods

The archive files of the patients administered to the
emergency department due to thoracic trauma and diagnosed to have sternal
fractures between January 2015 and December 2017 were reviewed for age, gender,
type of trauma, type of injury, associated injuries, and clinical outcome.

Results

There were 27 male, and 6 female patients. The mean
age was 48.9 ± 16.50 years (20-79). The most frequent cause was vehicle
accident. The sternal fracture was isolated in 13, and associated with other
injuries in 20 patients. Eight of the isolated fracture patients and all of the
latter were hospitalized. Six of the patients underwent tube thoracostomy, one
bilateral. When the length of hospital stay is compared between the two groups,
sternal fracture with associated injury patients stayed in the hospital for
significantly longer periods.

 

Conclusion

Although isolated sternal fracture is benign in nature
and may be treated with basic measures, when associated with other injuries, it
becomes more complicated to treat, and the length of hospital stay increases
significantly. 

Anahtar Kelimeler

Sternum Fracture, Associated Injuries

Sternum Fraktürü ve Eşlik Eden Yaralanmaların Özellikleri; Üç Yıllık Klinik Deneyim Sternum Fraktürü ve Eşlik Eden Yaralanmalar

Öz

Amaç;

Sternum fraktürleri,
göğüs travması sonrası acil serviste görülen patolojilerden küçük bir yüzdesini
oluşturmasına rağmen, kardiyak yaralanmaların habercisi olabilmeleri nedeni ile
tanı ve izlemleri önem taşımaktadır. Amaç bu hastaların tanı izlem ve
tedavisindeki yaklaşımları tartışmaktır.

Yöntem;

Çalışma Ocak 2015 –
Aralık 2017 tarihleri arasında göğüs travması sebebi ile acil servise başvuru
yapan ve sternum fraktürü tanısı alan 33 hastanın demografik özellikleri ve
klinik özellikleri retrospektif olarak değerlendirildi.

Bulgular;

Hastaların 27’si erkek,
6’sı kadındı. Yaş ortalaması 48.9 ± 16.50 (20-79) olarak tespit edildi. En sık
görülen etiyolojik neden trafik kazası olarak bulundu. Hastaların 13’ünde izole
sternum fraktürü tespit edilirken 20’sinde komplike fraktür görüldü. Eşlik eden
en sık travmatik patoloji kot fraktürü olarak tespit edildi. İzole fraktürlerin
8’i hastaneye yatırılırken komplike fraktürlerin tamamının izlemi hastaneye
yatırılarak tedeavisi yapıldı. Olguların 6 sına tüp torakostomi uygulandı.
Hastanede yatış süreleri açısından değerlendirildiğinde komplile sternum
fraktürü mevcut olan hastaların izole fraktürlere göre istatistiksel olarak
anlamlı bir şekilde uzun olduğu tespit edildi .

Sonuç;

İzole sternum fraktürleri
medikal yöntemlerle güvenle yönetilerek hastanede kalış süresi kısa, iyi
prognozlu travmalar olarak değerlendirebilir. Eşlik eden yaralanma tespit
edilen hastalarda meydana gelen patolojiler nedeniyle hem hastanede kalış
süresi hem de morbiditenin arttığı kanısındayız.

Anahtar Kelimeler

Sternum Fraktürü, Eşlik Eden Yaralanmalar

Kaynakça

• 1. Sirmali M, Türüt H, Topçu S, et al. A comprehensive analysis of traumatic rib fractures: morbidity, mortality and management Eur J Cardio Surg 2003;24:133-138.
• 2. Galan G, Peiialver JC, Paris E et al. Blunt chest injuries in 1696 patients Eur J Cardio Surg 1992;6:284-287.
• 3. Brookes JG, Dunn RJ, Rogers IR. Sternal fractures: a retrospective analysis of 272 cases. J Trauma 1993;35:46–54
• 4. Roy-Shapira A, Levi I, Khoda J. Sternal fractures: a red flag or a red herring? J Trauma 1994;37:59–61
• 5. Porter RS, Zhao N. Patterns of injury in belted and unbelted individuals presenting to a trauma center after motor vehicle crash: seat belt syndrome revisited. Ann Emerg Med 1998;32:418–424
• 6. Ziegler DW, Agarwal NN. The morbidity and mortality of rib fractures. J Trauma 1994;37:975-979.
• 7. Horikawa A, Miyakoshi N, Kodama H, and Shimada Y. Insufficiency Fracture of the Sternum Simulating Myocardial Infarction: Case Report and Review of the Literature. Tohoku J Exp Med 2007:211;89-93.
• 8. Hills MW, Delprado AM, Deane SA. Sternal fractures: associated injuries and management. J Trauma 1993;35:55–60.
• 9. Demirhan Ö, Kaynak MK. Thoracic traumas. Solunum 2003;6:320-337
• 10. Bilgin M, Akcalı Y, Hasdıraz L, et al. Isolated sternal fractures: a hallmark of violent injury. Turk Goğus Kalp Damar Cer Derg 2009;17:33-35
• 11. Richardson JD, Grover FL, Trinkle JK. Early operative management of isolated sternal fractures. J Trauma 1975; 15:156- 158
• 12. Crestanello JA, Samuels LE, Kaufman MS, et al. Sternal fracture with mediastinal hematoma: delayed cardiopulmonary sequelae. J Trauma 1999;47:161–164
• 13. Saab M, Kurdy NM, Birkinshaw R. Widening of the mediastinum following a sternal fracture. Int J Clin Pract 1997;51:256–257
• 14. Athanassiadi K, Gerazounis M, Moustardas M, Mataxas E. Sternal fractures: a retrospective analysis of 100 cases. World J Surg 2002;26:1243-1246.
• 15. Von Garrel T, Ince A, Junge A, Schnabel M, Bahrs C. The sternal fracture: a radiographic analysis of 200 fractures with special reference to concomitant injuries. J Trauma 2004;57:837-844.
• 16. Potaris K, Gakidis J, Mihos P, Voutsinas V, Deligeorgis A, Petsinis V. Management of sternal fractures: 239 cases. Asian Cardiovasc Thorac Ann 2002;10:145–149.
• 17. Velissaris T, Tang AT, Patel A, et al. Traumatic sternal fracture: outcome following admission to a Thoracic Surgical Unit. Injury 2003;34:924-927
• 18. Uluşan A, Karakurt Ö. Cardiac findings of sternal fractures due to thoracic trauma: A five-year retrospective study. Ulus Travma Acil Cerrahi Derg 2018;24:249-254.
• 19. Celik B, Sahin E, Nadir A, et al. Sternum fractures and effects of associated injuries. Thorac Cardiovasc Surg. 2009;57:468-471.
• 20. Harley DP, Mena I. Cardiac and vascular sequelae of sternal fractures. J Trauma 1986;26:553-555.
• 21. Gouldman J, Miller RS. Sternal fracture: A benign entity? Am Surg 1997;63:17-19.
• 22. Wiener Y, Achildiev B, Karni T, Halevi A. Echocardiogram in the sternal fracture. Am J Emerg Med 2001;19:403-405.