title: Spontaneous sternal fracture due to multiple myeloma requiring extensive surgical repair.
abstract: Spontaneous sternal fracture is a well-known complication of multiple myeloma due to osteolytic bone lesions. The possibility of a multiple myeloma should be thoroughly investigated in patients presenting with a spontaneous sternal fracture. This work up should go beyond protein electrophoresis alone as a monoclonal paraprotein is not always present. In some cases, the myeloma plasma cell clone produces only the free light chain (κ or λ) or may even be non-secretory. The underlying plasma cell dyscrasia is treated with chemotherapy and, if needed, local radiotherapy. However, for patients with a fracture causing persistent pain and physical discomfort, internal fixation may be additionally required. We present a case of a patient who presented with a displaced pathological sternal fracture. She was treated with chemotherapy, radiotherapy and an open reduction and internal fixation with a Locking Compression Plate (LCP). This technique offers a feasible option for rigid fixation of pathological fractures.
authors.affiliation: Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
authors.forename: Ellen M Bp
authors.initials: EM
authors.lastname: Reuling
authors.affiliation: Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
authors.forename: Tijs S C
authors.initials: TS
authors.lastname: Jakma
authors.affiliation: Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
authors.forename: Johannes Marco
authors.initials: JM
authors.lastname: Schnater
authors.affiliation: Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
authors.forename: Peter E
authors.initials: PE
authors.lastname: Westerweel
mesh_terms: D001860:Bone Plates; D059248:Chemoradiotherapy; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D005598:Fractures, Spontaneous / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D013249:Sternum / Q000293:injuries* / Q000601:surgery*