Şimşek Sadullah, Özmen Cihan Akgül, Onat Serdar
Dicle University, Medical School, Diyarbakır, Turkey.
Radiol Bras. 2022 May-Jun;55(3):167-172. doi: 10.1590/0100-3984.2021.0074.
To examine the relationship that the types and locations of fractures of the sternum have with mortality and morbidity.
We analyzed the records of 115 patients diagnosed with fracture of the sternum, due to blunt trauma, between 2007 and 2018. Records of computed tomography studies were obtained from the radiology archive of a tertiary teaching hospital. The type of fracture was classified as linear, displaced, or comminuted, whereas the fracture location was classified as the manubrium, body, or xiphoid process.
A total of 108 patients were included in the study. Of those patients, 92 (85.2%) were male and 16 (14.8%) were female. The etiology was a traffic accident in 72 cases (62.6%) and a fall from height in 36 (31.3%). The mean age was 42.1 ± 17.7 years for males and 53.9 ± 20.0 years for females. The mortality rate was 11.1%. Among the 12 deceased patients, the mean age was 44.4 ± 18.3 years. The fracture was located exclusively in the manubrium in 64 patients (59.3%), exclusively in the body of the sternum in 41 (38.0%), and in both locations in three (2.7%), whereas none were located in the xiphoid process. Morbidity rates were higher in the patients with fractures of the manubrium than in those with fractures of the body of the sternum, as was the incidence of accompanying bone fractures and organ injuries. The fracture was linear in 44 patients (40.7%), displaced in 62 (57.4%), and comminuted in 30 (27.8%). The mortality was significantly higher for comminuted fractures than for the other fracture types ( = 0.045; β = 4.40).
Fracture of the manubrium can be indicative of the severity of trauma and has a poor prognosis.
研究胸骨骨折的类型和部位与死亡率及发病率之间的关系。
我们分析了2007年至2018年间115例因钝性创伤诊断为胸骨骨折患者的记录。计算机断层扫描研究记录取自一家三级教学医院的放射科档案。骨折类型分为线性、移位或粉碎性，而骨折部位分为胸骨柄、胸骨体或剑突。
本研究共纳入108例患者。其中，男性92例（85.2%），女性16例（14.8%）。病因是交通事故72例（62.6%），高处坠落36例（31.3%）。男性平均年龄为42.1±17.7岁，女性为53.9±20.0岁。死亡率为11.1%。在12例死亡患者中，平均年龄为44.4±18.3岁。64例患者（59.3%）骨折仅位于胸骨柄，41例（38.0%）仅位于胸骨体，3例（2.7%）位于两个部位，而无骨折位于剑突。胸骨柄骨折患者的发病率高于胸骨体骨折患者，伴发骨折和器官损伤的发生率也是如此。44例患者（40.7%）骨折为线性，62例（57.4%）为移位性，30例（27.8%）为粉碎性。粉碎性骨折的死亡率显著高于其他骨折类型（P = 0.045；β = 4.40）。
胸骨柄骨折可提示创伤的严重程度，预后较差。
