外傷性胸骨骨折に対する早期の胸骨固定術

Early Sternum Fixation with a Locking Plate for Traumatic Sternal Fracture

外傷性胸骨骨折の症例では，転位が大きい場合や骨折による他臓器損傷を認める場合に外科的治療が考慮される．しかし，手術適応は明確ではなく，保存的加療が選択される症例が多い．われわれは，胸郭動揺を呈した胸骨骨折に対して受傷後早期に固定術を行い，良好な転帰をたどった症例を経験したため報告する．

An 86-year-old man fell from a farm trolley and presented with chest bruising. Chest computed tomography showed a hemopneumothorax, multiple right rib fractures, and a sternal fracture at the sternal angle. Although he was treated with a chest tube for drainage and external fixation, a flail chest and severe pain continued. We performed a locked plate fixation of the sternal fracture on the 6th day of hospitalization. The postoperative course was favorable and the patient’s flail chest improved. In cases of fracture of the sternum, minimally invasive locked plate sternal fixation may lead to early recovery.