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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Management of Vertical Sternal Fracture Nonunion in Elite-Level Athletes
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Management of Vertical Sternal Fracture Nonunion in Elite-Level Athletes

机译：精英级运动员垂直胸骨骨折缠绕术的管理

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Background: Sternal fractures are rare, and they can be treated nonoperatively. Vertical sternal fractures have rarely been reported. Purpose: To describe the management and surgical treatment of a series of elite-level athletes who presented with symptomatic nonunions of a vertical sternal fracture. Study Design: Case series; Level of evidence, 4. Methods: Patients with an established symptomatic nonunion of a vertical sternal fracture, as diagnosed by computed tomography (CT) or magnetic resonance imaging (MRI), underwent open reduction and internal fixation using autologous bone graft and cannulated lag screws. The patients were assessed preoperatively and at the final follow-up using the Rockwood sternoclavicular joint (SCJ) score; Constant score; and shortened version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores. Bony union was confirmed on postoperative CT scan. Results: Five patients (4 men and 1 woman) were included; all were national- or international-level athletes (rugby, judo, show-jumping, and MotoGP). The mean age at surgery was 23.4 years (range, 19-27 years), the mean time from injury to referral was 13.6 months (range, 10-17 months), and the mean time from injury to surgery was 15.8 months (range, 11-20 months). The mean follow-up was 99.4 months (range, 25-168 months). There was a significant improvement after surgery in the mean Rockwood SCJ score (from 12.6 to 14.8 [ P & .05]), Constant score (from 84 to 96.4 [ P & .05]; 80% met the minimal clinically important difference [MCID] of 10.4 points), and QuickDASH (from 6.8 to 0.98 [ P & .05]; 0% met the MCID of 15.9 points). Four of the patients were able to return to sport at their preinjury level, and 1 patient retired for nonmedical reasons. All of the fractures had united on the postoperative CT scan. There were no postoperative complications. Conclusion: Vertical fractures of the sternum are very rare and tend to behave clinically like an avulsion fracture injury to the capsuloligamentous structure of the inferior SCJ. The requirement of advanced imaging to diagnose this injury means that the actual incidence and natural history are not known. For high-demand athletes, early identification, surgical reduction, and fixation are likely to achieve the best outcome.
机译：背景：胸骨骨折是罕见的，它们可以是非手产的。垂直胸骨骨折很少报道。目的：描述一系列精英级运动员的管理和手术治疗，他们呈现出垂直胸骨骨折的症状不矛盾。研究设计：案例系列;证据水平，4.方法：患者患有垂直胸骨骨折的既定症状非，如由计算的断层扫描（CT）或磁共振成像（MRI）诊断，使用自体骨移植和插管滞后螺钉进行开放的开放和内固定。术前和最终进行评估患者使用Rockwood Sternoclavicular关节（SCJ）得分;不断分数;并缩短了手臂，肩膀和手（QuickDash）分数的障碍版本。在术后CT扫描上确认了骨头联盟。结果：包括五名患者（4名男子和1名女性）;所有国家都是国家或国际级运动员（橄榄球，柔道，展示跳跃和MotoGP）。手术的平均年龄为23.4岁（范围，19-27岁），来自转诊的平均时间为13.6个月（范围，10-17个月），手术伤害的平均时间为15.8个月（范围，范围， 11-20个月）。平均随访时间为99.4个月（范围，25-168个月）。手术后平均岩石SCJ得分（从12.6到14.8 [P＆amp; 05]），恒定得分（从84到96.4 [P＆amp; .05]; 80％遇见了最小临床上重要的区别差异[mcid]为10.4点），QuickDash（从6.8到0.98 [P＆amp; .05]; 0％达到15.9分的MCID）。四名患者能够在他们的前津属返回运动，1例患者因非医疗原因退休。所有骨折都在术后CT扫描方面团结起来。没有术后并发症。结论：胸骨的垂直骨折是非常罕见的，倾向于在尿液骨灰损伤临床上表现为下SCJ的涂层结构。提前成像的要求诊断这种伤害意味着实际发病率和自然历史尚不清楚。对于高需求运动员，早期鉴定，手术减少和固定可能会达到最佳结果。

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