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Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling

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Tamponade following sternoclavicular dislocation surgical fixation.

H Bensafi¹, J-M Laffosse, S A Taam

¹Department of Orthopaedic Surgery and Traumatology, Musculo-skeletal Institute, Toulouse-Rangueil Teaching Hospital Center, 1, avenue Jean-Poulhès, TSA 50032, 3159 Toulouse cedex 9, France.

Orthopaedics & Traumatology, Surgery & Research : OTSR

|May 22, 2010

Summary

This case study details surgical repair of posterior sternoclavicular dislocation using the Burrows technique. Temporary wire fixation led to a rare complication, pericardiac tamponade, highlighting its contraindication for sternoclavicular joint surgery.

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Area of Science:

Orthopedic surgery
Trauma management
Surgical techniques

Background:

Posterior sternoclavicular dislocation is a rare but serious injury.
Surgical intervention is sometimes required for reduction and stabilization.
The Burrows technique with wire fixation is one described method.

Observation:

A patient underwent surgical reduction and tenodesis for posterior sternoclavicular dislocation.
Temporary wire fixation was employed as part of the Burrows technique.
Postoperative pericardiac tamponade developed due to bleeding from brachiocephalic blood vessels.

Findings:

The complication of pericardiac tamponade was successfully managed with emergency drainage and hardware removal.
The case demonstrates an exceptional but severe risk associated with wire fixation in sternoclavicular joint surgery.
This complication suggests wire fixation is contraindicated for sternoclavicular joint stabilization.

Implications:

Surgeons should reconsider the use of temporary wire fixation for sternoclavicular joint stabilization.
Alternative fixation methods should be explored to avoid this rare but life-threatening complication.
Enhanced vigilance for vascular complications is crucial following sternoclavicular joint surgery.