Sternal fractures associated with spinal injury.

Area of Science:

• Orthopedics
• Trauma Surgery
• Radiology

Background:

• Sternal fractures and dislocations can occur with or without associated spinal injuries.
• Previous studies have highlighted the potential link between sternal and spinal trauma.
• The diagnostic challenge lies in identifying these associated injuries, especially with suboptimal imaging.

Purpose of the Study:

• To review sternal fractures and dislocations for associated spinal injuries.
• To determine the incidence and characteristics of spinal injuries in patients with sternal trauma.
• To emphasize the importance of evaluating for concurrent spinal injuries.

Main Methods:

• Retrospective review of 28 cases of sternal fractures and/or dislocations.
• Analysis of patient records and radiographs to identify associated spinal injuries.
• Categorization of fracture types, injury mechanisms, and displacement patterns.

Main Results:

• Eight out of nine patients with adequate imaging for sternal injury evaluation had associated spine fractures.
• All identified spine fractures were consistent with a flexion injury mechanism.
• Posterior displacement of the manubrial fragment was noted in patients with spine injury and manubriosternal dislocations.
• Three patients with sternal injuries had unrecognized spine fractures during hospitalization.

Conclusions:

• Sternal fractures and dislocations warrant a high index of suspicion for associated spinal injuries, especially flexion-type injuries.
• Indirect sternal injuries may be overlooked, necessitating careful evaluation.
• A comprehensive assessment for spinal injuries is recommended in all patients presenting with sternal fractures, and vice versa.