• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.10 no.2
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• pp.51-60
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• 2015

Objectives: The purpose of this study is to investigate the safety, injury mechanism, complication and adverse reactions associated with Chuna manual theraphy(CMT), to report one case of adverse reaction with Thai Massage(TM). Methods: A 76-year-old woman presented with chest pain and dorsalgia. The patient undertook a TM. The patient's chest pain didn't improve by Korean medecine. In MRI study, sternal fracture was diagnosed. Results and Conclusions : It is supposed that this patient suffered chest pain and dorsalgia due to a TM. From this case, we can understand the etiology of sternal fracture to some extent and consider the complication of Chuna manual theraphy through TM. In addition, This study raises the awareness of the possibility of a sternal fracture caused by a low-energy CMT technique.

• Journal of Chest Surgery
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• v.28 no.2
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• pp.218-220
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• 1995

This 51 years old male patient was admitted to the department of thoracic and cardiovascular surgery via OPD because of anterior chest pain. 7days before admission, He got the chest trauma after traffic accidents,the lateral chest roentgenogram showed complete transverse sternal fracture. He also complained of mild dyspnea. We also noticed that he had depressed anterior chest wall. It looks like funnel chest. The operative findings revealed dislocated & callus formations at the both 4th and 5th costochondral junction and transverse fracture of sternal body between 4th and 5th costochondral junction, the upper end of sternal fracture was situated below the lower end of sternal fracture. The two ends of sternal fracture were situated at the same level and reapproximated the two ends by two-interrupted wire sutures. The patient is well on the road to recovery after the operation.

• Journal of Trauma and Injury
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• v.34 no.3
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• pp.170-176
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• 2021

Purpose: Traumatic sternal fractures are rare but quite disabling injuries. Timely fixation of sternal fractures reduces pain and prevents respiratory complications. However, the fixation technique should be simple, effective, and readily available in local circumstances. Methods: From January 2014 to March 2020, seven patients with sternal fracture/dislocation underwent steel wire fixation with the new "Timala" technique. In this technique, adjacent ribs are anchored with two steel wires to form an "X" in front of the fractured segment of the sternum. Patients were followed up clinically and radiologically. Results: Six of the patients were men and one was a female. Five of them had injuries due to falls and two were injured in road traffic accidents. Their age ranged from 18 years to 76 years, with a median age of 41 years. All seven patients experienced immediate recovery from pain and showed evidence of fracture healing on postoperative chest X-rays and clinical examinations. Conclusions: Anchoring ribs to fix the sternum with steel wire is a safe, effective, easily available, and reproducible method to fix sternal fractures or dislocations.

• Journal of Trauma and Injury
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• v.23 no.2
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• pp.175-179
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• 2010

Purpose: Sternal fractures after blunt thoracic trauma can cause significant pain and disability. They are relatively uncommon as a result of direct trauma to the sternum and open reduction is reserved for those with debilitating pain and fracture displacement. We reviewed consecutive 11 cases of open reduction and fixation of sternum and tried to find standard approach to the traumatic sternal fractures with severe displacement. Methods: From December 2008 to August 2010, the medical records of 11 patients who underwent surgical reduction and fixation of sternum for sternal fractures with severe displacement were reviewed. We investigated patients' characteristics, chest trauma, associated other injuries, type of open reduction and fixation, combined operations, preoerative ventilator support and postoperative complications. Results: The mean patient age was 59.3years (range, 41~79). The group comprised 6 male and 5 female subjects. Among 11 patients who underwent open reduction and fixation for sternal fracture with severe displacement, 6 cases had isolated sternal fractures and the other 5 patients had associated other injuries. Sternal fractures were caused by car accidents (9/11, 81.8%), falling down (1/11, 9.1%) and direct blunt trauma to the sternum (1/11, 9.1%), respectively. 3 of the 7 patients (42.9%) who underwent sternal plating with longitudinal plates showed loosening of fixation. Otherwise, none of the 4 patients who underwent surgical fixation using T-shaped plate had stable alignment of the fracture. Conclusion: Sternal fractures with severe displacement need to be repaired to prevent chronic pain, instability of the anterior chest wall, deformity of the sternum, and even kyphosis. In the present study, a T-shaped plate with a compression-tension mechanism constitutes the treatment of choice for displaced sternal fractures.

• Journal of Chest Surgery
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• v.49 no.5
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• pp.361-365
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• 2016

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.

• Journal of Chest Surgery
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• v.28 no.6
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• pp.601-605
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• 1995

Clinical evaluations were performed on 54 cases of the traumatic sternal fracture, those were admitted and treated at the department of Thoracic and Cardiovascular Surgery in Chosun University Hospital during the past 5 years period from January 1990 to December 1994. The frequency was about 7.8% of the nonpenetrating chest trauma. The ratio of male to female was 2 : 1 in male predominance. Average age was 45.7 years old and age distribution was from 18 to 80 years old. The most common cause in the sternal fracture were high decelerating injury[ 38 cases . The most common fracture site was sternal body. Associated intrathoracic organ injuries were cardiac contusion[11cases , hemopneumothorax and pulmonary contusion. Added, thoracic cage and extrathoracic organ injuries were rib fracture, head injuries, thoracic spinal fracture and long bone fracture. Abnormal ECG findings were sinus bradycardia[4 cases , sinus tachycardia[3 cases , bundle branch block, atrial fibrillaton, left ventricular hypertrophy and myocardial ischemia. The average days of admission was 19.1 days. All patients were treated with conservative treatment. The complications after treatment were atelectasis[2 cases ,empyema[1 cases , ARDS[1 cases .

• Journal of Chest Surgery
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• v.23 no.5
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• pp.916-921
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• 1990

Clinical observations were performed on 17 cases of the traumatic sternal fracture, those were admitted and treated at the department of thoracic and cardiovascular surgery in Chosun University Hospital during the past 6 years 5months period from January 1983 to May 1989. Obtained results were as follows: 1. The frequency was about 4.8% of the nonpenetrating chest trauma. 2. The ratio of male to female was 16: 1 in male predominance and age distribution was from 24 to 62 years old. 3. The common cause were high decelerating injury [impact of the steering column] and falling down[more than 3 m in high]. 4. The most common fracture site was sternal body and next was sternomanubrial junction. 5. Associated intrathoracic organ injuries were cardiac contusion [6 cases], hemopneumothorax[1 Case], mediastinal bleeding[1 case], and thoracic cage and extrathoracic organ injuries were rib fracture, head injuries, thoracic spinal fracture, and long bone fracture. 6. Abnormal EGG findings were sinus bradycardia[1 case], bundle branch block [2 cases], and sinus tachycardia[3 cases]. 7. The operative reduction and fixation was necessary in only one case and the others were treated with conservative treatment.

• Journal of Trauma and Injury
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• v.29 no.4
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• pp.184-186
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• 2016

Although sternal fractures are relatively common, treatment has not been clarified. Thus, the authors report a case of a patient with a sternal fracture associated with a thoracic spinal fracture who had received conservative treatment, but the outcome was not satisfactory.

• Journal of Chest Surgery
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• v.36 no.3
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• pp.211-214
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• 2003

Sternal fracture is relatively common in chest trauma. Mediastinal hematoma secondary to sternal fracture is not in common, and it has minor symptoms such as mild dyspnea and chest tightness, which usually resolve spontaneously. We experienced two cases of extrapericardial tamponade by hematoma caused by sternal fractures. Two patients were diagnosed by chest CT scan and sent to the operating room within 2 hours after arriving at emergency room because of unstable vital signs. Cardiovascular signs were relieved immediatly after the operation. We report these cases with a brief review of the literature.

• Journal of Trauma and Injury
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• v.36 no.4
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• pp.362-368
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• 2023

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.