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Osteosynthesis of sternal fractures with double locking compression plate fixation: a retrospective cohort study

  • Nina Kalberer
  • Herman FrimaEmail author
  • Christian Michelitsch
  • Jan Kloka
  • Christoph Sommer
Original Article • THORAX - TRAUMA
  • 48 Downloads

Abstract

Purpose

Sternal fractures are rare injuries and mostly treated non-operatively. In selected cases, internal fixation becomes necessary. No standard operative approach has been determined yet among experts. The aim of this study is to describe our treatment algorithm and results after operative stabilisation of sternal fractures with locking compression plates (LCP), mainly focusing on the functional outcome.

Methods

A retrospective cohort study was conducted. We included all patients after operative stabilisation of a sternal fracture between 2008 and 2016. Endpoints were the functional outcome using the Activities of Daily Living (ADL) score, pain analysed by the numeric rating scale (NRS), breathing ability, complications and implant removal.

Results

Eighteen out of 153 (12%) patients with a sternal fracture underwent operation. Three patients were lost to follow-up. Eleven out of 15 (73%) patients were treated with double straight LCP 3.5 mm implants and 4 (27%) patients with pre-countered LCP 3.5 mm implants. Mean follow-up was 57 months. The median ADL score was 1 (1–4), the median NRS was 0 (0–9), and respiratory complaints scored a median of 1 (1–4). No non-union, hardware failure or implant-related complication occurred. Post-operative complications were pneumonia (20%) and respiratory insufficiency (20%). Implants were removed in 4/15 (27%) patients; three times due to implant-related irritation, once on patient’s request.

Conclusion

Operative stabilisation of sternal fractures with double LCP 3.5 mm provides excellent long-term functional results and seems to be an appropriate option for internal fixation. The rate of post-operative complications is low; however, 27% had a second operation for implant removal.

Keywords

Sternum Sternal fracture Operative fixation Osteosynthesis Locking plate fixation Functional outcome 

Notes

Author contributions

All authors contributed to the study conception and design. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Funding

There was no external source of funding for this study.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Kantonale Ethikkommission Zürich, BASEC-Nr. 2017 – 01650) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Trauma SurgeryKantonsspital GraubündenChurSwitzerland
  2. 2.Department of AnaesthesiologyUniversitätsklinikum Frankfurt am MainFrankfurt am MainGermany

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