Norotte G, Peres E, Vanderweyen A, Razafindralasitra P
Service de chlrurgie orthopédique et traumatologique, Centre Hospitalier Général, Gap.
Rev Chir Orthop Reparatrice Appar Mot. 1997;83(3):283-5.
The authors report one operated case of traumatic sternal segmental dislocation in a child, and propose a mechanism for this uncommon lesion. A fourteen year old boy was admitted in emergency for anterior chest pain, occurring during an exercise in parallel bars without any fall. X ray showed traumatic dislocation of the upper sternal segment. After 12 hours, because of bad clinical tolerance (pain, dyspnea with sweats and disphagia) reduction and plate stabilization (Senegas plate) was performed with immediate pain relief. The boy returned to school after 10 days. Plate was removed two months later after healing, with good clinical and radiological results. According to rare published cases, conservative treatment can be proposed in very young children because of dislocation remodeling. By others, in case of bad tolerance, surgical treatment is suggested despite the inconvenient of device's removal. The originality of this case is the indirect lesion mechanism. Hypothesis is given by authors. Treatment by plate is easy and gives immediate pain relief with good clinical and radiological results in teen-agers.
作者报告了一例儿童创伤性胸骨节段性脱位的手术病例，并提出了这种罕见损伤的机制。一名14岁男孩因在双杠锻炼时出现前胸疼痛而急诊入院，当时并无摔倒情况。X线显示胸骨上段创伤性脱位。12小时后，由于临床耐受性差（疼痛、呼吸困难伴出汗及吞咽困难），进行了复位及钢板固定（塞内加斯钢板），术后疼痛立即缓解。该男孩10天后返校。两个月后骨折愈合取出钢板，临床及影像学结果良好。根据罕见的已发表病例，由于脱位可重塑，对于非常年幼的儿童可考虑保守治疗。另一些人则认为，在耐受性差的情况下，尽管存在取出固定装置的不便，仍建议进行手术治疗。本病例的独特之处在于其间接损伤机制。作者给出了相关假设。对于青少年，采用钢板治疗操作简便，能立即缓解疼痛，临床及影像学结果良好。
