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Sternal segment dislocation in children
Akifusa Wada1, Toshio Fujii, Kazuyuki Takamura
1Fukuoka Children's Hospital, Fukuoka, Japan.
Insights
Sternal segment dislocation in children, though rare, can occur from direct blows, indirect forces, or osteomyelitis. Conservative management is often effective, with segments remodeling and stabilizing without surgery.
Area of Science:
- Pediatric Orthopedics
- Pediatric Traumatology
Background:
- Sternal segment dislocation is a rare condition in pediatric patients.
- Understanding the mechanisms and outcomes is crucial for appropriate management.
Observation:
- Three pediatric cases of sternal segment dislocation are presented.
- Mechanisms included direct blow, indirect forces, and osteomyelitis.
- Dislocations occurred at the manubrium-body or first-second sternal segment junctions.
Findings:
- Dislocated sternal segments gradually rotated over approximately two weeks.
- Segments stabilized naturally after the rotation period.
- Conservative observation was employed during the dislocation phase.
- All dislocated sternal segments demonstrated remodeling.
Implications:
- Surgical intervention for sternal segment dislocation in children may not always be necessary.
- Conservative management can lead to favorable outcomes, including segment remodeling and stabilization.
- This case series highlights the potential for non-operative resolution of pediatric sternal dislocations.
Abstract:
Three cases of sternal segment dislocation in children are described. The primary mechanisms were direct blow in a 4-year-old boy, indirect forces in a 3-year-old boy, and osteomyelitis in a 10-year-old boy. The two former cases were dislocated at the junction of the manubrium with the sternal body, and the latter case was at the junction of the first and second sternal segments. The dislocated segments were gradually rotated for approximately 2 weeks and were finally stabilized after rotation. While in the dislocated state, the patients were observed conservatively, although all the dislocated segments were remodeled. Surgical treatment of sternal segment dislocation is not inevitable.