Scheyerer Max J, Zimmermann Stefan M, Bouaicha Samy, Simmen Hans-Peter, Wanner Guido A, Werner Clément M L
Division of Trauma Surgery, Department of Surgery, University Hospital Zurich, Raemistraße 100, 8091 Zürich, Switzerland.
Emerg Med Int. 2013;2013:407589. doi: 10.1155/2013/407589. Epub 2013 Nov 13.
Introduction. Sternal fractures often occur together with serious and life-threatening additional injuries. This retrospective study was designed to assess concomitant injuries and develop a correlation between fracture location and the severity of injury. Methods. All patients (n = 58) diagnosed with a fracture of the sternum by means of a CT scan were analysed with respect to accident circumstances, fracture morphology and topography, associated injuries, and outcome. Results. Isolated sternal fractures occurred in 9%. In all other admissions, concomitant injuries were diagnosed: mainly rip fractures (64%), injury to the head (48%), the thoracic spine (38%), lumbar spine (27%), and cervical spine (22%). Predominant fracture location was the manubrium sterni. In these locations, the observed mean ISS was the highest. They were strongly associated with thoracic spine and other chest injuries. Furthermore, the incidence of head injuries was significantly higher. ICU admission was significantly higher in patients with manubrium sterni fractures. Conclusion. Sternal fractures are frequently associated with other injuries. It appears that the fracture location can provide important information regarding concomitant injuries. In particular, in fractures of manubrium sterni, the need for further detailed clinical and radiologic workup is necessary to detect the frequently associated injuries and reduce the increased mortality.
引言。胸骨骨折常与严重且危及生命的其他损伤同时发生。本回顾性研究旨在评估合并伤，并建立骨折部位与损伤严重程度之间的相关性。方法。对所有通过CT扫描诊断为胸骨骨折的患者（n = 58）进行分析，内容包括事故情况、骨折形态和部位、合并伤以及预后。结果。孤立性胸骨骨折发生率为9%。在所有其他入院病例中，均诊断出合并伤：主要为肋骨骨折（64%）、头部损伤（48%）、胸椎损伤（38%）、腰椎损伤（27%）和颈椎损伤（22%）。主要骨折部位是胸骨柄。在这些部位，观察到的平均损伤严重度评分（ISS）最高。它们与胸椎和其他胸部损伤密切相关。此外，头部损伤的发生率显著更高。胸骨柄骨折患者入住重症监护病房（ICU）的比例显著更高。结论。胸骨骨折常与其他损伤相关。骨折部位似乎可为合并伤提供重要信息。特别是在胸骨柄骨折中，需要进一步进行详细的临床和影像学检查，以发现常合并的损伤并降低增加的死亡率。
