sternum fracture
Introduction
Introduction to sternal fracture The sternum is a tough flat bone, and the traumatic sternal fracture accounts for 1.5% to 5% of the chest injury. Mostly caused by direct violence or squeezing force acting on the chest, such as car crash, house collapse and bruise, blunt blow, body chest in the chest during hard movement, etc., excessive flexion of the spine can also cause sternal fracture . A scapular fracture caused by a stab wound is less common. basic knowledge The proportion of illness: 0.004% Susceptible people: no specific population Mode of infection: non-infectious Complications: pneumothorax
Cause
Cause of sternal fracture
Violence factor (65%):
The sternal fracture is caused by violence directly affecting the chest wall, causing the chest wall to be severely impacted or squeezed. It is more common due to a car accident or a direct impact injury, or it can be caused by direct compression of a blister and a blunt instrument. Injury, the site of injury is mostly located in the sternum, mostly transverse fracture, which occurs at the junction of the sternum and sternum or the sternum. Indirect violence causes fractures in the distance through longitudinal conduction, leverage or torsion. When the foot falls from a height, the trunk flexes forward rapidly due to gravity, and the vertebral body at the junction of the thoracolumbar spine is subjected to folding force. The role of compression fracture (conduction).
Accumulated strain (20%):
Long-term, repeated, slight direct or indirect damage in life and work can cause a specific part of the limb to become a cumulative strain, which can easily lead to sternal fracture.
Prevention
Prevention of sternal fracture
There is no effective preventive measure for this disease, mainly to pay attention to the safety of daily life. For patients with combined intrathoracic organ damage, they should be actively rescued and sent to the hospital.
Complication
Complications of sternal fracture Complications
Thoracic fractures are rare in chest trauma, and can be combined with large blood vessels of the heart, chest wall blood vessels and tracheal pleural injury, causing pleural hemorrhage, pneumothorax and abnormal thoracic breathing. The injury is complicated and can lead to serious consequences for sternal fractures. In combination with chest and abdomen organ injury, due to the strong external force, there are usually multiple rib fractures, the proportion of the formation of the sacral chest is higher, the stability of the thorax is poor, prone to abnormal breathing, respiratory and circulatory failure in a short time; At the same time, combined with chest and abdomen organ damage, it is more complicated, dangerous, and even cause the death of the patient. Therefore, surgical treatment should be actively carried out for such patients.
Symptom
Symptoms of sternal fracture Common symptoms Chest pain sternal fissure weakness Abdominal respiratory abnormal right chest pain
Main symptoms: The patient's multiple symptoms are numbness and paresthesia of the lower extremities (about 70% of the two); unilateral or bilateral lower extremity weakness, difficulty walking (about 60% or more); 50% of patients have a cotton sensation while walking; 40% of patients have chest and abdomen belt sensation or other symptoms, such as radiation pain, back pain and so on.
Signs: Mainly manifested as dystrophic muscles in the unilateral or bilateral lower extremities. The sensation of the thoracic pulp damaged segment is weakened or disappeared, and may be accompanied by weakened shallow reflexes, pyramidal tract signs and sphincter dysfunction.
Examine
Examination of sternal fracture
The auxiliary examination of the fracture mainly relies on X-ray examination:
X-ray examination of the lateral lateral plain film can be seen in the fracture line. The diagnosis of sternal fracture is easy. Generally, there is a history of traumatic injury. Some patients with unclear medical history and clinical manifestations are not dependent on the lateral position or oblique of the sternum. X-ray films are used for diagnosis and can generally be diagnosed. If a combined injury is suspected, a B-ultrasound scan is required.
Diagnosis
Diagnosis and diagnosis of sternal fracture
diagnosis
The diagnosis of sternal fractures is not difficult, and there are fewer diseases that need to be identified clinically, mainly to prevent missed diagnosis.
According to the history of traumatic chest injury, chest pain, shortness of breath, purpura, local contusion, hematoma, tenderness, bone friction, combined with chest X-ray examination, the main reasons for early missed diagnosis are: mediastinal and The sternum shadow overlaps, the chest X-ray film is not easy to show; other serious injuries such as multiple rib fractures in the chest and the whole body, such as multiple rib fractures, blood pneumothorax, pulmonary contusion, craniocerebral injury, especially coma, cover the sternal fracture, especially for non-displacement. Thoracic fractures are more likely to be missed. For patients with suspected sternal fractures, sternal or oblique X-ray films should be taken to confirm the diagnosis. Ultrasound is also more accurate and rapid in the diagnosis of sternal fractures (especially sternal fractures). .
Differential diagnosis
Need to be associated with multiple rib fractures, blood pneumothorax, pulmonary contusion, and brain injury.
