Department of Trauma Surgery, University Medical Centre Utrecht, Suite G04.232, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
Department of Orthopaedic Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands.
Int Orthop. 2019 Jun;43(6):1455-1464. doi: 10.1007/s00264-018-3945-4. Epub 2018 Apr 26.
Traumatic sternal fractures are rare injuries. The most common mechanism of injury is direct blunt trauma to the anterior chest wall. Most (> 95%) sternal fractures are treated conservatively. Surgical fixation is indicated in case of fracture instability, displacement or non-union. However, limited research has been performed on treatment outcomes. This study aimed to provide an overview of the current treatment practices and outcomes of traumatic sternal fractures and dislocations.
A systematic review of literature published from 1990 to June 2017 was conducted. Original studies on traumatic sternal fractures, reporting sternal healing or sternal stability were included. Studies on non-traumatic sternal fractures or not reporting sternal healing outcomes, as well as case reports (n = 1), were excluded.
Sixteen studies were included in this review, which reported treatment outcomes for 191 patients. Most included studies were case series of poor quality. All patients showed sternal healing and 98% reported pain relief. Treatment complications occurred in 2% of patients.
Treatment of traumatic sternal fractures and dislocations is an underexposed topic. Although all patients in this review displayed sternal healing, results should be interpreted with caution since most included studies were of poor quality.
创伤性胸骨骨折较为少见。最常见的损伤机制为前胸部直接钝性创伤。大多数（>95%）胸骨骨折采用保守治疗。若存在骨折不稳定、移位或不愈合，应进行手术固定。然而，针对治疗结果的研究较为有限。本研究旨在概述创伤性胸骨骨折和脱位的当前治疗方法和结果。
对 1990 年至 2017 年 6 月期间发表的文献进行系统综述。纳入了报告胸骨愈合或胸骨稳定性的关于创伤性胸骨骨折的原始研究。排除了非创伤性胸骨骨折或未报告胸骨愈合结果的研究以及病例报告（n=1）。
本综述纳入了 16 项研究，共报道了 191 例患者的治疗结果。大多数纳入的研究为质量较差的病例系列研究。所有患者均显示胸骨愈合，98%的患者报告疼痛缓解。2%的患者发生治疗并发症。
创伤性胸骨骨折和脱位的治疗是一个研究较少的课题。尽管本综述中的所有患者均显示胸骨愈合，但应谨慎解释结果，因为大多数纳入的研究质量较差。
