title: Treatment of middle-super thoracic fractures associated with the sternum fracture.
abstract: To analyze the characteristics and treatment of middle-super thoracic fractures associated with the sternum fracture, twenty six patients with middle-super thoracic fractures associated with the sternum fracture were retrospectively reviewed. The intimate information of patients including age, gender, cause of injury, site of the sternal fracture, level and type of thoracic vertebral fracture, spinal cord injury and associated injuries were included in the analysis. There were 12 compressed fractures, 11 fracture-dislocations, two burst fracture and one burst-dislocation in this study. Six patients had a complete lesion of the spinal cord, nine sustained a neurologically incomplete injury and 11 were neurologically intact. Nine patients were treated non-operatively and 17 were underwent surgery. All patients were followed up for 8~99 months. Our results showed that road traffic accidents (RTA) and fall were the dominated in the causes. All six patients with a complete paralytic lesion were not recovered with any significant function. Four out of eleven neurologically intact patients had local pain although ten of them remained normal function and one patient turn up tardive paralysis. One of nine patients with incomplete paraplegia returned to normal and four recovered with some function. These study suggested that the sternum is one of the important parts in constructing thoracic cage and plays an important role in maintain the stabilization of the thoracic vertebra. Because of the unique anatomy and biomechanics of the thoracic cage, the classification commonly applied to thoracic vertebra fractures is not suitable for middle-super thoracic fractures associated with the sternum fracture. Middle-super thoracic fractures associated with the sternum fracture was marked by violent force, severe fractures of spine, severe injuries of spinal cord and high incidence of associated injuries. These cases confirm the existence and clinical relevance of the fourth column of the thoracic spine and its role for spinal stability in the patient with middle-super thoracic fracture.
authors: Department of Orthopaedics, The 174th Hospital of PLA, Spinal Orthopaedics Center of PLA, Chenggong Hospital of Xiamen University Xiamen 361000, Fujian Province, China.
authors: Zheyuan
authors: Z
authors: Huang
authors: Department of Orthopaedics, The 174th Hospital of PLA, Spinal Orthopaedics Center of PLA, Chenggong Hospital of Xiamen University Xiamen 361000, Fujian Province, China.
authors: Fengrong
authors: F
authors: Chen
authors: Department of Orthopaedics, The 174th Hospital of PLA, Spinal Orthopaedics Center of PLA, Chenggong Hospital of Xiamen University Xiamen 361000, Fujian Province, China.
authors: Jianming
authors: J
authors: Huang
authors: Department of Orthopaedics, The 174th Hospital of PLA, Spinal Orthopaedics Center of PLA, Chenggong Hospital of Xiamen University Xiamen 361000, Fujian Province, China.
authors: Guojian
authors: G
authors: Jian
authors: Department of Orthopaedics, The 174th Hospital of PLA, Spinal Orthopaedics Center of PLA, Chenggong Hospital of Xiamen University Xiamen 361000, Fujian Province, China.
authors: Hao
authors: H
authors: Gong
authors: Department of Orthopaedics, The 174th Hospital of PLA, Spinal Orthopaedics Center of PLA, Chenggong Hospital of Xiamen University Xiamen 361000, Fujian Province, China.
authors: Tianrui
authors: T
authors: Xu
authors: Department of Orthopaedics, The 174th Hospital of PLA, Spinal Orthopaedics Center of PLA, Chenggong Hospital of Xiamen University Xiamen 361000, Fujian Province, China.
authors: Bowen
authors: B
authors: Wang
authors: Department of Orthopaedics, The 174th Hospital of PLA, Spinal Orthopaedics Center of PLA, Chenggong Hospital of Xiamen University Xiamen 361000, Fujian Province, China.
authors: Ruisong
authors: R
authors: Chen
authors: Department of Orthopaedics, The 174th Hospital of PLA, Spinal Orthopaedics Center of PLA, Chenggong Hospital of Xiamen University Xiamen 361000, Fujian Province, China.
authors: Xiaolin
authors: X
authors: Chen
authors: Department of Orthopaedics, The 174th Hospital of PLA, Spinal Orthopaedics Center of PLA, Chenggong Hospital of Xiamen University Xiamen 361000, Fujian Province, China.
authors: Zhiyang
authors: Z
authors: Ye
authors: Department of Orthopaedics, The 174th Hospital of PLA, Spinal Orthopaedics Center of PLA, Chenggong Hospital of Xiamen University Xiamen 361000, Fujian Province, China.
authors: Jun
authors: J
authors: Wang
authors: Department of Orthopaedics, The 174th Hospital of PLA, Spinal Orthopaedics Center of PLA, Chenggong Hospital of Xiamen University Xiamen 361000, Fujian Province, China.
authors: Desheng
authors: D
authors: Xie
authors: Department of Orthopaedics, The 174th Hospital of PLA, Spinal Orthopaedics Center of PLA, Chenggong Hospital of Xiamen University Xiamen 361000, Fujian Province, China.
authors: Haoyuan
authors: H
authors: Liu
keywords: Thoracic vertebral fractures; sternal fractures; thoracic cage