Huang Zheyuan, Yi Bilong, Liu Haoyuan, Chen Fengrong, Huang Jianming, Gong Hao, Xu Tianrui, Jian Guojian, Wang Bowen, Chen Ruisong, Wang Jun, Ye Zhiyang
Department of Orthopaedics, Chenggong Hospital Affiliated to Xiamen University, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2011 Dec;36(12):1199-205. doi: 10.3969/j.issn.1672-7347.2011.12.013.
To determine the characteristics, classification, and treatment of thoracic fracture accompanied with sternum fracture.
Data of 32 patients with thoracic fractures accompanied with sternum fracture were reviewed. Patients information such as age, gender, cause of injury, site of sternum fracture, level and type of thoracic vertebral fracture, spinal cord injury and associated injuries was included in the analysis. Of the 32 patients, 13 had compressed fractures, 13 had fracture-dislocations, 5 had burst fracture and 1 had burst-dislocation. Six patients had a complete lesion of the spinal cord, 13 sustained a neurologically incomplete injury, and the other 13 were neurologically intact. Ten patients were treated nonoperatively and the other 22 surgically.
All patients were followed up for 10-103 months. Road traffic accidents and falling dominated among the causes. All patients were accompanied with other injuries. None of the 6 patients with a complete paralitic lesion regained any significant function. Of the 13 neurologically intact patients, 5 had local pain although 12 of them remained normal function. One patient showed tardive paralysis. Three of the 13 patients with incomplete paraplegia returned to normal, 5 regained some function and 5 did not recover.
Thoracic fractures accompanied with sternum fracture are marked by violent force, severe fracture of the spine, severe injuries of the spinal cord, and high incidence of other injuries. The new classification method is more suitable to thoracic fractures accompanied with sternum fracture,and confirms the existence and clinical relevance of the 4th column of the thoracic spine and its role in providing spinal stability in patients with thoracic fracture.
确定胸椎骨折伴胸骨骨折的特点、分类及治疗方法。
回顾32例胸椎骨折伴胸骨骨折患者的数据。分析患者的年龄、性别、受伤原因、胸骨骨折部位、胸椎骨折的节段和类型、脊髓损伤及合并伤等信息。32例患者中，13例为压缩骨折，13例为骨折脱位，5例为爆裂骨折，1例为爆裂脱位。6例患者脊髓完全损伤，13例为神经功能不完全损伤，其余13例神经功能正常。10例患者接受非手术治疗，其余22例接受手术治疗。
所有患者均随访10 - 103个月。受伤原因以道路交通事故和坠落为主。所有患者均合并其他损伤。6例完全性瘫痪患者均未恢复任何显著功能。13例神经功能正常的患者中，5例有局部疼痛，尽管其中12例功能仍正常。1例患者出现迟发性瘫痪。13例不完全性截瘫患者中，3例恢复正常，5例恢复部分功能，5例未恢复。
胸椎骨折伴胸骨骨折具有暴力损伤、脊柱严重骨折、脊髓严重损伤及合并伤发生率高的特点。新的分类方法更适用于胸椎骨折伴胸骨骨折，证实了胸椎第四柱的存在及其临床相关性，以及其在胸椎骨折患者提供脊柱稳定性中的作用。
