Krinner S, Schmitt S, Grupp S, Hennig F F, Langenbach A, Schulz-Drost S
Unfallchirurgische Abteilung, Universitätsklinikum Erlangen, Krankenhausstr. 12, 91054, Erlangen, Deutschland.
Klinik für Unfallchirurgie und Orthopädie, BG Klinikum Unfallkrankenhaus Berlin gGmbH, Warener Str. 7, 12683, Berlin, Deutschland.
Unfallchirurg. 2018 Aug;121(8):642-648. doi: 10.1007/s00113-018-0460-4.
Combinations of sternal and spinal fractures often occur due to high velocity accidents and are associated with a high incidence of concomitant injuries. The anterior thoracic wall is described as the fourth column of torso stability, which is why sternovertebral injuries (SVI) present a high risk of sagittal deformation of the trunk, in particular injuries of the thoracic spine. To date, no studies have been published on the frequency distribution of the involved vertebral bodies in large patient groups.
This study was intended to elaborate a frequency distribution of vertebral fractures accompanying sternal fractures (SF) and examine the risk of a vertebral fracture accompanying a SF.
A total of 48,193 cases with the main or secondary diagnosis of a SF and 897,963 cases with vertebral fractures based on routine data of German hospitals from the years 2005-2012 were evaluated. A concomitant injury to the spinal column was examined for each vertebral body and then evaluated statistically.
Of all patients with a SF 30.96% also suffered from a vertebral fracture. Of these 3.11% were SF as the main diagnosis and 60.89% the secondary diagnosis. While vertebral fractures generally occurred most frequently in the region of the thoracolumbar transition and the second cervical vertebral body, the SVI showed a further frequency peak in the range from the lower cervical spine to the middle thoracic spine. The present study was able to show a frequency distribution of accompanying vertebral body injuries in a large and representative collective in the case of SF for the first time.
胸骨骨折和脊柱骨折常因高速事故而同时发生，且常伴有其他损伤。前胸壁被描述为躯干稳定性的第四支柱，这就是为什么胸骨-脊柱损伤（SVI）会导致躯干矢状面变形的高风险，尤其是胸椎损伤。迄今为止，尚未有关于大型患者群体中受累椎体频率分布的研究发表。
本研究旨在阐述胸骨骨折（SF）伴发椎体骨折的频率分布，并研究SF伴发椎体骨折的风险。
基于2005 - 2012年德国医院的常规数据，对48193例主要或次要诊断为SF的病例以及897963例椎体骨折病例进行了评估。对每个椎体检查是否伴有脊柱损伤，然后进行统计学评估。
在所有胸骨骨折患者中，30.96%也患有椎体骨折。其中，3.11%以胸骨骨折作为主要诊断，60.89%作为次要诊断。虽然椎体骨折通常最常发生在胸腰段移行区和第二颈椎椎体区域，但胸骨-脊柱损伤在从下颈椎到胸椎中部的范围内显示出另一个频率高峰。本研究首次能够在一个大型且具有代表性的群体中展示胸骨骨折伴发椎体损伤的频率分布。
