title: Concomitant Sternal Fracture in Flail Chest: An Analysis of 21,741 Polytrauma Patients from the TraumaRegister DGU®.
abstract: BackgroundIsolated sternal fractures (SFs) rarely show complications, but their influence in a thorax trauma of the seriously injured still remains unclear.MethodsA retrospective analysis of the TraumaRegister DGU®was performed involving the years 2009 to 2013 (Injury Severity Score [ISS] ≥ 16, primary admission to a trauma center). Cohort formation: Unilateral and bilateral flail chest (FC) injuries with and without a concomitant SF, respectively.ResultsIn total, 21,741 patients (25% female) met the inclusion criteria, with 3,492 (16.1%) showing SF. Unilateral FC patients were on average 53.6 ± 18.4 years old, and bilateral FC patients were on average 55.2 ± 17.7 years old. The ISS in unilateral FC and bilateral FC amounted to 31.2 ± 13.0 and 43.4 ± 13.1 points, respectively. FC with an SF occurred more frequently as an injury to car occupants and less frequently as an injury to motorcyclists or in injuries due to falls.ConclusionPatients with an SF additional to an FC had longer hospital and intensive care unit stays and were longer artificially respirated than those patients without an SF. SF indicates possible cardiac and thoracic spine injuries.
authors.affiliation: Department of Trauma and Orthopedic Surgery, University Hospital Erlangen, Erlangen, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Schulz-Drost
authors.affiliation: Department of Trauma and Orthopedic Surgery, University Hospital Erlangen, Erlangen, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Krinner
authors.affiliation: Department of Trauma and Orthopedic Surgery, University Hospital Erlangen, Erlangen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Langenbach
authors.affiliation: Department of Trauma and Orthopedic Surgery, University Hospital Erlangen, Erlangen, Germany.
authors.forename: Pascal
authors.initials: P
authors.lastname: Oppel
authors.affiliation: Institute for Research in Operative Medicine (IFOM), University of Witten/Herdecke, Cologne Merheim Medical Center (CMMC), Cologne, Germany.
authors.forename: Rolf
authors.initials: R
authors.lastname: Lefering
authors.affiliation: Department of Orthopedic and Trauma Surgery, St. Theresien Krankenhaus, Nuremberg, Germany.
authors.forename: Dominic
authors.initials: D
authors.lastname: Taylor
authors.affiliation: Department of Trauma and Orthopedic Surgery, University Hospital Erlangen, Erlangen, Germany.
authors.forename: Friedrich F
authors.initials: FF
authors.lastname: Hennig
authors.affiliation: Department of Orthopedic and Trauma Surgery, St. Theresien Krankenhaus, Nuremberg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Mauerer
mesh_terms: D000058:Accidental Falls; D000063:Accidents, Traffic; D000328:Adult; D000368:Aged; D001642:Bicycling; D005260:Female; D005409:Flail Chest / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D050723:Fractures, Bone / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015601:Injury Severity Score; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009049:Motorcycles; D009104:Multiple Trauma / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D000069636:Pedestrians; D012042:Registries; D012121:Respiration, Artificial; D012189:Retrospective Studies; D013249:Sternum / Q000293:injuries*; D013997:Time Factors; D014193:Trauma Centers; D016896:Treatment Outcome