Occult manubriosternal dislocation-role of manubrio-vertebral column

Traumatic manubriosternal joint dislocation in blunt thoracic trauma is of rare occurrence with only few case reports in the literature. We present a rare case of occult manubriosternal dislocation that was evident only after cervico-dorsal spine fracture correction. Thirty-one-year-old gentleman sustained multiple fractures of C6, C7, and D1 vertebral bodies; bilateral transverse process of C7, D1,and D3; left transverse process of D12; right transverse process of D4; and right clavicle fracture along with bilateral multiple rib fractures after fall from bike at high velocity. The patient was awake, alert, and moving all 4 limbs. The patient underwent right chest drain insertion in high dependency unit. His displaced cervico-thoracic spine was fixed with plate and intrapedicular screws. It was after fixation of spine that type II manubriosternal dislocation was clinically appreciated. He underwent fixation of manubriosternal joint using simple steel wires. Post-operatively he remained pain-free with stable manubriosternal joint. Role of manubrio-vertebral column in such a scenario is discussed.