title: Analysis of Sternal Fixation Results According to Plate Type in Sternal Fracture.
abstract: BACKGROUND
  Sternal fractures are relatively rare, and caused mainly by blunt anterior chest wall trauma. In most cases, sternal fractures are treated conservatively. However, if the patient exhibits problematic symptoms such as intractable chest wall pain or bony crepitus due to sternal instability, surgical correction is indicated. But no consensus exists regarding the most appropriate surgical method. We analyzed the results of surgical fixation in cases of sternal fracture in order to identify which surgical method led to the best outcomes.
  
  
  METHODS
  We retrospectively reviewed the medical records of patients with sternal fractures from December 2008 to December 2011, and found 19 patients who underwent open reduction and internal fixation of the sternum with a longitudinal plate (L-group) or a T-shaped plate (T-group). We investigated patients' characteristics, clinical details regarding each case of chest trauma, the presence of other associated injuries, the type of open reduction and fixation, whether a combined operation was performed, and postoperative complications.
  
  
  RESULTS
  Of the 19 patients, 10 patients (52.6%) were male, and their average age was 56.8 years (range, 32 to 82 years). Seven patients (36.8%) had isolated sternal fractures, while 12 (63.2%) had other associated injuries. Seven patients (36.8%) were in the L-group and 12 patients (63.2%) were in the T-group. Three patients in the L-group (42.9%) showed a loosening of the fixation. In all patients in the T-group, the fracture exhibited stable alignment.
  
  
  CONCLUSIONS
  Open reduction and internal fixation with a T-shaped plate in sternal fractures is a safer and more efficient treatment method than treatment with a longitudinal plate, especially in patients with a severely displaced sternum or anterior flail chest, than a longitudinal plate.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine.
authors.forename: Chun Sung
authors.initials: CS
authors.lastname: Byun
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine.
authors.forename: Il Hwan
authors.initials: IH
authors.lastname: Park
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Konyang University Hospital, Konyang University College of Medicine.
authors.forename: Wan Jin
authors.initials: WJ
authors.lastname: Hwang
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Konyang University Hospital, Konyang University College of Medicine.
authors.forename: Yeiwon
authors.initials: Y
authors.lastname: Lee
authors.affiliation: Department of Trauma Surgery, Pusan National University Hospital Trauma Center.
authors.forename: Hyun Min
authors.initials: HM
authors.lastname: Cho
keywords: Bone plates; Fracture fixation; Sternum; Thoracic injuries