Sternal fractures in children

Abstract

BACKGROUND: Sternal fractures are a rare nosological form of injuries in children. The injuries of the sternum often are accompanied by fractures of the long bones of the skeleton or thoracic vertebrae. Isolated fractures of the sternum in children are rarely diagnosed. The medical information on pediatric sternum injuries is limited by a small number of scientific publications. AIM: Our aim is to study the peculiarities of traumagenesis, clinic, diagnostics, treatment of sternal fractures in children. MATERIALS AND METHODS: Clinical material for the served as experience in providing traumatology assistance to 8 children who received sternal fractures. The average age of the injured children was 11.5 years. 87.5% of the victims were boys. In all patients, sternal fractures had been diagnosed along with other damage to the musculoskeletal system. During the survey, traditional diagnostic methods for emergency traumatology were used. RESULTS: The leading mechanism of injury, i.e., falling from a height of 2 meters and more were found in 62.5% of victims. In all clinical observations, fractures were localized at the level of the body of the sternum. All the children, besides sternal fractures, had uncomplicated fractures of the vertebral bodies. A total of 30 bodies of the vertebrae were compressed. Most often (in 16.75% of cases), the ThV vertebra was compressed. The reliable symptoms of sternal fractures in patients were difficult and painful breathing, local swelling of soft tissues, soreness of the sternum during palpation, and amplification of the pain in the fracture area during pressure applied on half of the chest. Compliance with the strict bed mode on the roller-reclinator under the area of the compreated vertebrae and the exclusion of the axial load on the spine was a favorable fact sufficient and led to pain disappearance in 37 days. In all cases, the sternum fractures did not require any surgery. Fractures of the bodies of the vertebrae in 7 children were also treated conservatively. The Corsets Orlett was used for immobilization, ensuring a reliable degree of fixation. The average hospital stay amounted to 16. The duration of the hospital stay was influenced by the accompanying bone-articular damage to the skeleton. The evaluation of the long-term results was performed in 4 children. The results were interpreted as good. CONCLUSIONS: When applying for emergency traumatology assistance to children with chest injury and spine, it is necessary to purposefully explore the state of the sternum.