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J Biomech Eng 2021 Apr 20. Epub 2021 Apr 20.

Manufacturing and Automation Research Center, Koc University, Istanbul 34450, Turkey.

Background: AISI 316L stainless steel wire cerclage routinely used in sternotomy closure causes lateral cut-through damage and fracture, especially in cases of high-risk patients, which leads to post-operative complications. A biocompatible elastomer (Pellethane®) coating on the standard wire is proposed to mitigate the cut-through effect.

Methods: Simplified peri-sternal and trans-sternal, sternum-cerclage contact models are created and statically analyzed in a finite element (FE) software to characterize the stress-reduction effect of the polymer coating for thicknesses between 0. Read More

Arch Orthop Trauma Surg 2021 Apr 12. Epub 2021 Apr 12.

Department of Traumatology and Reconstructive Surgery, BG Trauma Centre Tuebingen, Eberhard Karls University Tuebingen, Schnarrenbergstr. 95, 72076, Tuebingen, Germany.

Introduction: The aim of this study was to present recent epidemiological data on extremity and axial skeletal fractures in German hospitals and to compare them with older data to detect time trends.

Materials And Methods: Inpatient data from the German National Hospital Discharge Registry were used. The absolute number and age-standardized incidence of fractures in 2002 and 2018 were analysed by fracture location according to the International Classification of Disease. Read More

J Coll Physicians Surg Pak 2021 Mar;31(3):330-333

Department of Orthopaedics, Wuhan Hospital of Traditional Chinese Medicine, Wuhan, China.

Osteoporotic vertebral compression fracture (OVCF) is a common disease among the elderly individuals. With the aging of the population development, the incidence of OVCF is increasing. Cementation of vertebral body like percutaneous vertebroplasty (PVP) is a minimally invasive and effective treatment. Read More

JBJS Case Connect 2021 03 9;11(1). Epub 2021 Mar 9.

Department of Orthopaedic Surgery, Regions Hospital, St. Paul, Minnesota.

Case: We present the case of a 57-year-old woman who sustained a comminuted transverse sternal fracture that failed primary open reduction internal fixation (ORIF). The patient underwent staged nonunion reconstruction with a tricortical iliac crest bone graft and mesh plate. With 18 months of a sustained successful outcome, we propose a treatment strategy for a challenging clinical problem. Read More

Chest 2021 Mar;159(3):e167-e171

Division of Cardiovascular Medicine, Michigan State University College of Human Medicine, Frederik Meijer Heart & Vascular Institute, Spectrum Health, Grand Rapids, MI.

Case Presentation: A 40-year-old woman presented with recurrent syncope. She reported multiple (>20) episodes of non-prodromal loss of consciousness, periodically provoked by physical exertion. One episode resulted in a nasal fracture due to the abrupt nature of her syncope. Read More

Trauma Case Rep 2021 Apr 18;32:100430. Epub 2021 Feb 18.

Department of Thoracic and Cardiovascular Surgery, Dankook University Hospital, Cheonan 31116, Republic of Korea.

Traumatic cardiac injury is not rare. Especially cardiac contusion with sternal fracture due to blunt trauma in common. But cardiac rupture due to direct injury from fractured sternum in very rare. Read More

BMJ Case Rep 2021 Mar 2;14(3). Epub 2021 Mar 2.

Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.

A 73-year-old male patient underwent operative treatment for dislocation of multiple costochondral junctions alongside multiple bony rib fractures and a flail chest following high-energy trauma. During the operative fixation of the flail chest, the costochondral lesions were surgically stabilised with plates and screws, which were fixated on the osseous anterior rib, sternum or the rib cartilage. The patient experienced no pulmonary complications during the primary admission. Read More

Stapp Car Crash J 2020 Nov;64:155-212

Injury Biomechanics Research Center, The Ohio State University.

The objective of this study was to generate biomechanical corridors from post-mortem human subjects (PMHS) in two different seatback recline angles in 56 km/h sled tests simulating a rear-facing occupant during a frontal vehicle impact. PMHS were placed in a production seat which included an integrated seat belt. To achieve a repeatable configuration, the seat was rigidized in the rearward direction using a reinforcing frame that allowed for adjustability in both seatback recline angle and head restraint position. Read More

Zhonghua Yi Xue Za Zhi 2021 Feb;101(7):481-486

Department of Medical Imaging, Jinling Hospital, the First School of Clinical Medicine, Southern Medical University, Nanjing, 210002, China.

To investigate the diagnostic efficacy and potential application value of deep learning-based chest CT auxiliary diagnosis system in emergency trauma patients. A total of 403 patients, including 254 males and 149 females aged from 16 to 100 (50±19) years, who received emergency treatment for trauma and chest CT examination in the Eastern Theater General Hospital from September 2019 to November 2019 were retrospectively analyzed. Dr. Read More

J Cardiothorac Surg 2021 Feb 15;16(1). Epub 2021 Feb 15.

Department of Thoracic Surgery, the Second Hospital of Hebei Medical University, No. 215, Heping west road, Shijiazhuang, 050000, China.

Objective: To explore the clinical effect of 3D printing combined with framework internal fixation technology on the minimally invasive internal fixation of high complex rib fractures.

Methods: Total 16 patients with high complex rib fractures were included in the study. Before the procedure, the 3D rib model was reconstructed based on the thin-layer chest CT scan. Read More

Turk J Emerg Med 2021 Jan-Mar;21(1):20-23. Epub 2020 Dec 1.

Department of Emergency Medicine, School of Medicine, Erciyes University, Kayseri, Turkey.

Objectives: Sternal fractures (SFs) are rare pathologies that mainly occur as a result of traffic accidents, which can cause mortality due to concomitant complications. In this study, we aimed to evaluate clinical processes and termination status of patients diagnosed with a SF in the emergency department.

Methodology: Patients diagnosed with a SF in the emergency department during 8 years were retrospectively reviewed. Read More

Khirurgiia (Mosk) 2021 (2):53-57

Petrovsky Russian Research Center of Surgery, Moscow, Russia.

Objective: To assess the possibilities of omentoplasty for prevention of complications after redo sternum osteosynthesis for traumatic rupture.

Material And Methods: The study included 53 patients with recurrent sternal diastasis. Greater omentum was additionally implanted in 19 (35. Read More

Clin Pract Cases Emerg Med 2021 Feb;5(1):85-88

University of Nevada Las Vegas, Department of Cardiology, Las Vegas, Nevada.

Introduction: Blunt chest trauma and motor vehicle collisions are common presentations to the emergency department (ED). Chest pain in a trauma patient can usually and reasonably be attributed to chest wall injury, leading to a potential delay in diagnosis and treatment.

Case Report: In this case report, we present a 52-year-old male who was brought to the ED with complaints of chest pain and pressure after a motor vehicle collision. Read More

J Forensic Leg Med 2021 Feb 15;78:102113. Epub 2021 Jan 15.

Istanbul University-Cerrahpaşa, Cerrahpasa Faculty of Medicine, Forensic Medicine Department, 34303, Istanbul, Turkey. Electronic address:

Falls from height are the most common cause of blunt trauma after traffic accidents. The focus of this retrospective study was to analyze the relationship between injuries in fatal falls and fall height, body mass index (BMI), and sex in 206 autopsy reports. Age, sex, weight, height, place of the fall, fall height, period between the incidence and death, external examination findings in the autopsy, intracranial findings, fractures, internal organ injuries, and information about the causes of death were recorded. Read More

Acta Radiol 2021 Jan 17:284185120981571. Epub 2021 Jan 17.

Department of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.

Background: Isolated sternal fracture, a benign injury, has been increasing in the pan-scan era, although one-third of patients with sternal fracture still has trouble with concomitant injury. The differentiation of these two entities is important to optimize patient management.

Purpose: To evaluate correlation between retrosternal hematoma and concomitant injury in patients with sternal fracture and to identify predicting factors for concomitant injury in sternal fracture. Read More

Unfallchirurg 2021 Jan 12. Epub 2021 Jan 12.

Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Waldeyerstraße 1, 48149, Münster, Deutschland.

This article reports the case of a 69-year-old patient with multiple rib fractures and sternal fracture after repetitive cardiopulmonary resuscitation (CPR). Because of secondary respiratory failure due to an unstable thorax, rib fixation was performed 10 days after CPR. Subsequently, ventilation improved resulting in successful extubation 4 days after rib plating. Read More

Eur J Trauma Emerg Surg 2021 Jan 2. Epub 2021 Jan 2.

Division of Trauma, Emergency General Surgery and Critical Care Surgery, Department of Surgery, University of Nebraska Medical Center, 983280 Nebraska Medical Center, Omaha, NE, 68198-3280, USA.

Introduction: Sternal fractures are debilitating due to intractable pain, constant fracture movement and limited range of motion (ROM) of the upper extremities (UE). Traditional treatment comprises mainly of pain control, delaying return to daily activities. Recently, sternal fixation has gained popularity. Read More

Cureus 2020 Nov 22;12(11):e11628. Epub 2020 Nov 22.

Department of Trauma Surgery, Mercy St. Vincent Medical Center, Toledo, USA.

Background Clinically significant injuries are often missed in trauma patients with low-risk mechanisms of injury and lack of "red flags," such as abnormal vital signs. The purpose of this retrospective analysis was to evaluate the efficacy of computed axial tomography (CT) for identifying occult injuries in a high-volume trauma center. Methods Records from our institutional trauma registry were retrospectively extracted, examining encounters from January 2015 to October 2019. Read More

Leg Med (Tokyo) 2021 Feb 11;48:101828. Epub 2020 Dec 11.

Department of Legal Medicine, Shiga University of Medical Science, Tsukinowa, Seta, Otsu, Shiga 520-2192, Japan.

Background: Cardiopulmonary resuscitation (CPR) sometime cause severe injuries and can affect quality of life, lead to long-term disabilities or death of the patient. The aim of this study is to identify the risk factors causing CPR-induced injuries and those of serious injuries.

Methods: This was a retrospective forensic autopsy study in a single institution. Read More

Trop Doct 2020 Dec 23:49475520981264. Epub 2020 Dec 23.

Trauma Surgeon, Department of Trauma Surgery KGMU, Lucknow, India.

The incidence of sternal fracture ranges from 3 to 8%. In more than half, they are associated with other organ trauma such as blunt cardiac injuries, rib, scapular or vertebral fractures. Hence, the presence of sternal fracture is considered a marker for significant transmission of energy. Read More

JSES Int 2020 Dec 15;4(4):719-723. Epub 2020 Jul 15.

Department of Orthopaedics, University of Utah School of Medicine, Salt Lake City, UT, USA.

Background: Various surgical strategies have been used for the treatment of sternoclavicular joint instability with variable results. The purpose of this study was to report the clinical results of patients who underwent single-loop allograft reconstruction for sternoclavicular joint instability.

Methods: A total of 10 patients underwent single-loop allograft reconstruction for sternoclavicular joint instability from June 2012 to August 2014 by a single surgeon. Read More

Oper Orthop Traumatol 2020 Dec 8. Epub 2020 Dec 8.

Klink für Unfallchirurgie, Orthopädie und Plastische Chirurgie, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland.

Objective: Surgical stabilization of patients with flail chest, dislocated serial rib and sternal fractures, posttraumatic deformities of the thorax, symptomatic non-unions of the ribs and/or sternum, and weaning failure to biomechanically stabilize the thorax and avoid respirator-dependent complications.

Indications: Combination of clinically and radiologically observed parameters, such as pattern of thoracic injuries, grade of fracture dislocation, pathological changes to breathing biomechanics, and failure of nonsurgical treatment.

Contraindications: Acute hemodynamical instability and signs of systemic infection. Read More

Eur J Trauma Emerg Surg 2020 Dec 2. Epub 2020 Dec 2.

Department of Trauma Surgery and Reconstructive Surgery, BG Klinikum Bergmannstrost, Halle, Germany.

Purpose: The aim of this review is to systematically screen the literature for clinical and biomechanical studies dealing with posterior stabilization of acute traumatic mid-thoracic vertebral fractures in patients with normal bone quality.

Methods: This review is based on articles retrieved by a systematic search in the PubMed and Web of Science database for publications up to December 2018 dealing with the posterior stabilization of fractures of the mid-thoracic spine.

Results: Altogether, 1012 articles were retrieved from the literature search. Read More

Korean J Thorac Cardiovasc Surg 2020 Nov 25. Epub 2020 Nov 25.

Department of Thoracic and Cardiovascular Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.

A 63-year-old patient was admitted with a sternal fracture and mass. On evaluation, most of the body of the sternum had been destroyed by a tumor. Radical resection of the sternum was performed and part of the major pectoral muscles adherent to the sternal tumor was also resected. Read More

J Nepal Health Res Counc 2020 Nov 14;18(3):448-452. Epub 2020 Nov 14.

Department of Community Medicine, Lumbini Medical College and Teaching Hospital, Prabhas, Palpa.

Background: The clavicle, modified long bone, presents morphological and bilateral variations. This may be due to genetic factors, hormones, or environmental and occupational influences. Anthropometric studies in clavicle of Nepalese population using radiograph has not been reported to best of our knowledge. Read More

Eur J Cardiothorac Surg 2020 Nov 14. Epub 2020 Nov 14.

Department of Mechanical Engineering, Politecnico di Milano, Milan, Italy.

Objectives: Chest wall resections are most commonly performed for tumours, infection, radiation necrosis and trauma. Defects in the anterior chest greater than 5 cm, posterior defects more than 10 cm or resection including more than 3 ribs, independently of the location, require skeletal prosthetic reconstruction. The aim of this paper was to evaluate the strength of prostheses that reproduced the normal human anatomy using different materials subjected to the most dangerous loading conditions. Read More

Eur J Trauma Emerg Surg 2020 Oct 19. Epub 2020 Oct 19.

Department of General Surgery, Division of Trauma, Burns and Surgical Critical Care, University of California, Irvine, 333 City Blvd. West, Suite 1600, Orange, CA, 92868, USA.

Purpose: The incidence of sternal fractures in blunt trauma patients lies between 3 and 7%. The role, timing and indications for surgical management are not well delineated and remain controversial for patients undergoing surgical stabilization of sternum fracture (SSSF). We sought to identify the national rate of SSSF in patients with a sternum fracture hypothesizing patients undergoing SSSF will have a decreased rate of mortality and complications. Read More

Indian J Thorac Cardiovasc Surg 2020 Jul 2;36(4):388-396. Epub 2020 Jan 2.

Department of Cardio-Thoracic Surgery, S. Orsola Malpighi University Hospital, Via Massarenti 9, Bologna, BO Italy.

Purpose: Post-sternotomy dehiscence and mediastinitis remains a serious complication in cardiothoracic surgery. The aim of this work is to report our experience over a period of 8 years in the surgical treatment and risk factor analyses of post-sternotomy dehiscence and mediastinitis.

Methods: All patients treated for post-sternotomy dehiscence at our Thoracic Surgery Unit in the last 8 years were retrospectively collected. Read More

J Gen Fam Med 2020 Sep 7;21(5):188-190. Epub 2020 Jun 7.

Division of General Medicine Department of Comprehensive Medicine 1 Saitama Medical Center Jichi Medical University Saitama Japan.

An 82-year-old man with untreated diabetes mellitus (DM) had anterior chest wall swelling and ulcers 2 years following blunt chest trauma. Contrast-enhanced computed tomography revealed sternal fracture with osteolytic change and subcutaneous abscess. Blood and sternal cultures were positive for methicillin-susceptible (MSSA). Read More

Eur J Trauma Emerg Surg 2020 Oct 1. Epub 2020 Oct 1.

Department of Trauma Surgery, Medical Centre Utrecht, University, Suite G04.232, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands.

Purpose: Combined sternal and spinal fractures are rare traumatic injuries with significant risk of spinal and thoracic wall instability. Controversy remains with regard to treatment strategies and the biomechanical need for sternal fixation to achieve spinal healing. The present study aimed to assess outcomes of sternovertebral fracture treatment. Read More