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Sternum fracture: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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ICD-10 code
S22 Fracture of rib (ribs), sternum and thoracic spine.
[What causes a fracture of the sternum?
A fracture of the sternum occurs predominantly with a direct mechanism of injury. Displacement of fragments is often insignificant, but it can also be on bone thickness.
Anatomy of the sternum
The breast is referred to as long spongy bones. It consists of a handle, a body and a xiphoid process, connected by cartilaginous layers. The handle is articulated with the clavicles and is joined to the I ribs. When connected to the body, an angle is formed, open to the back - the angle of the sternum. The latter articulates with the second edge. The cartilage of the II-VII ribs joins the body. The sternum performs supporting and protective functions.
Symptoms of a fracture of the sternum
Victims complain of pain at the site of the fracture and difficulty breathing, resulting from pain and hemorrhage in the anterior mediastinum. Blood is poured out of a broken spongy bone.
Diagnosis of sternal fracture
Anamnesis
In the history - the corresponding trauma of the chest.
Examination and physical examination
When examined in the sternum, swelling and deformity are determined. Palpatorically, the sharp soreness, deformation due to edema, and sometimes due to the displacement of fragments.
Laboratory and instrumental research
The diagnosis is confirmed by a chest X-ray in the lateral projection. It should be noted that the performance and reading of chest radiographs are known difficulties, the diagnosis of a fracture of the sternum can be reliably made only if the picture shows a displacement of the fragments.
What do need to examine?
Treatment of a broken sternum
Indications for hospitalization
Treatment of a fracture of the sternum is conservative. Carried out in a hospital.
First aid
10 ml of a 2% solution of procaine and 0.5 ml of 70% alcohol are injected into the fracture site. A large amount of anesthetic should not be introduced, so as not to increase the volume of the retrosternal hematoma.
Non-drug treatment of sternal fractures
The patient is placed on the shield. If a displacement of fragments is detected, they are gradually compared by re-breaking the thoracic spine. In interlopatochnoe area podkladyvagot a roller-reclinator, on which the patient should lie for 2-3 weeks. UHF, quartz, mustard plasters, respiratory gymnastics are shown.
Medicamentous treatment of a fracture of a sternum
In the process of treatment, the fracture of the sternum is prescribed by anesthetics.
Surgical treatment of sternal fractures
Operative treatment of sternal fractures is rarely performed. A vertical incision is made above the fracture site, 6-8 cm long. Soft tissues are cut off to the right and to the left. In both fragments, two holes are made closer to the fracture line so that the end of the awl emanates from the spongy substance at the site of the fracture. Vertically to the sternum, an awl should not be installed to avoid damage to the mediastinal organs. Through the holes obtained, strong threads or wires are made, which, after repositioning, are fastened together with fragments by a P-shaped seam.
When osteosynthesis with spokes, the edges of the sternum are exposed to one or two intercostal spaces above and below the fracture. Correlate the fragments and hold them together crosswise (obliquely upwards) with spokes. The spokes should enter the upper segment for 3-4 cm, but do not leave it on the back surface! The ends of the spokes bite and bend.