1. Osteosynthesis of sternal fractures with double locking compression plate fixation: a retrospective cohort study
- Author
-
Herman Frima, Christian Michelitsch, Nina Kalberer, Jan Kloka, and Christoph Sommer
- Subjects
Adult ,Male ,medicine.medical_specialty ,Sternal fracture ,Sternum ,Databases, Factual ,medicine.medical_treatment ,Cohort Studies ,03 medical and health sciences ,Fracture Fixation, Internal ,Fractures, Bone ,0302 clinical medicine ,Injury Severity Score ,Rare Diseases ,Trauma Centers ,medicine ,Internal fixation ,Humans ,Orthopedics and Sports Medicine ,Plate fixation ,Aged ,Retrospective Studies ,Aged, 80 and over ,Fracture Healing ,Postoperative Care ,030222 orthopedics ,Osteosynthesis ,business.industry ,030208 emergency & critical care medicine ,Retrospective cohort study ,Middle Aged ,Compression (physics) ,medicine.disease ,Prognosis ,Surgery ,Treatment Outcome ,Female ,business ,Complication ,Tomography, X-Ray Computed ,Bone Plates ,Switzerland - Abstract
Sternal fractures are rare injuries and mostly treated non-operatively. In selected cases, internal fixation becomes necessary. No standard operative approach has been determined yet among experts. The aim of this study is to describe our treatment algorithm and results after operative stabilisation of sternal fractures with locking compression plates (LCP), mainly focusing on the functional outcome. A retrospective cohort study was conducted. We included all patients after operative stabilisation of a sternal fracture between 2008 and 2016. Endpoints were the functional outcome using the Activities of Daily Living (ADL) score, pain analysed by the numeric rating scale (NRS), breathing ability, complications and implant removal. Eighteen out of 153 (12%) patients with a sternal fracture underwent operation. Three patients were lost to follow-up. Eleven out of 15 (73%) patients were treated with double straight LCP 3.5 mm implants and 4 (27%) patients with pre-countered LCP 3.5 mm implants. Mean follow-up was 57 months. The median ADL score was 1 (1–4), the median NRS was 0 (0–9), and respiratory complaints scored a median of 1 (1–4). No non-union, hardware failure or implant-related complication occurred. Post-operative complications were pneumonia (20%) and respiratory insufficiency (20%). Implants were removed in 4/15 (27%) patients; three times due to implant-related irritation, once on patient’s request. Operative stabilisation of sternal fractures with double LCP 3.5 mm provides excellent long-term functional results and seems to be an appropriate option for internal fixation. The rate of post-operative complications is low; however, 27% had a second operation for implant removal.
- Published
- 2019