title: OCCULT MANUBRIOSTERNAL JOINT INJURY ASSOCIATED WITH FRACTURE OF THE THORACIC SPINE.
abstract: The authors report the occurrence of an occult manubriosternal joint injury in the initial evaluation on a patient with a thoracic spine fracture (T9). This T9 fracture was diagnosed in a 37-year-old man and was associated with a partial neurological deficit. At the initial evaluation, the radiographs produced did not show the manubriosternal joint injury. During rehabilitation, after surgical stabilization of the thoracic spine fracture, the patient suddenly felt an intense pain accompanied by deformation at the sternal level. From imaging examinations, manubriosternal luxation was diagnosed. Because of recurrence of the luxation and the incapacitating pain, open reduction and fixation of the manubriosternal joint had to be performed. At the 12-month follow-up, the patient presented complete recovery of the neurological lesion, consolidation of the arthrodesis on the T7-T11 vertebral segment and maintenance of the reduction of the manubriosternal joint, which was asymptomatic during daily activities.
authors.affiliation: Postgraduate of the Department of Biomechanics, Medicine and Rehabilitation of the Locomotor System, of the Hospital das Clínicas of the Ribeirão Preto School of Medicine- USP - Ribeirão Preto (SP), Brazil.
authors.forename: Carlos Fernando Pereira
authors.initials: CF
authors.lastname: da Silva Herrero
authors.affiliation: Postgraduate of the Department of Biomechanics, Medicine and Rehabilitation of the Locomotor System, of the Hospital das Clínicas of the Ribeirão Preto School of Medicine- USP - Ribeirão Preto (SP), Brazil.
authors.forename: Maximiliano Aguiar
authors.initials: MA
authors.lastname: Porto
authors.affiliation: Doctorate Professor of the Radiology Division of the Department of Clinical Medicine of the Ribeirão Preto School of Medicine - USP - Ribeirão Preto (SP), Brazil.
authors.forename: Marcello Henrique
authors.initials: MH
authors.lastname: Nogueira-Barbosa
authors.affiliation: Full Professor of the Department of Biomechanics, Medicine and Rehabilitation of the Locomotor System, of the Hospital das Clínicas of the Ribeirão Preto School of Medicine- USP - Ribeirão Preto (SP), Brazil.
authors.forename: Helton Luiz Aparecido
authors.initials: HL
authors.lastname: Defino
keywords: Manubrium; Spine; Sternum