Browse > Article
http://dx.doi.org/10.20408/jti.2021.0014

Sternal Fracture Fixation with a Steel Wire: The New "Timala" Technique  

Timala, Rabindra Bhakta (Department of Cardiothoracic and Vascular Surgery, B & B Hospital)
Panthee, Nirmal (Department of Cardiac Surgery, Shahid Gangalal National Heart Center)
Publication Information
Journal of Trauma and Injury / v.34, no.3, 2021 , pp. 170-176 More about this Journal
Abstract
Purpose: Traumatic sternal fractures are rare but quite disabling injuries. Timely fixation of sternal fractures reduces pain and prevents respiratory complications. However, the fixation technique should be simple, effective, and readily available in local circumstances. Methods: From January 2014 to March 2020, seven patients with sternal fracture/dislocation underwent steel wire fixation with the new "Timala" technique. In this technique, adjacent ribs are anchored with two steel wires to form an "X" in front of the fractured segment of the sternum. Patients were followed up clinically and radiologically. Results: Six of the patients were men and one was a female. Five of them had injuries due to falls and two were injured in road traffic accidents. Their age ranged from 18 years to 76 years, with a median age of 41 years. All seven patients experienced immediate recovery from pain and showed evidence of fracture healing on postoperative chest X-rays and clinical examinations. Conclusions: Anchoring ribs to fix the sternum with steel wire is a safe, effective, easily available, and reproducible method to fix sternal fractures or dislocations.
Keywords
Fracture; Sternum; Bone wires;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Nazerali RS, Hinchcliff K, Wong MS. Rigid fixation for the prevention and treatment of sternal complications. Ann Plast Surg 2014;72(Suppl 1):S27-30.   DOI
2 Brookes JG, Dunn RJ, Rogers IR. Sternal fractures: a retrospective analysis of 272 cases. J Trauma 1993;35:46-54.   DOI
3 Potaris K, Gakidis J, Mihos P, Voutsinas V, Deligeorgis A, Petsinis V. Management of sternal fractures: 239 cases. Asian Cardiovasc Thorac Ann 2002;10:145-9.   DOI
4 Krinner S, Grupp S, Oppel P, Langenbach A, Hennig FF, SchulzDrost S. Do low profile implants provide reliable stability in fixing the sternal fractures as a "fourth vertebral column" in sternovertebral injuries? J Thorac Dis 2017;9:1054-64.   DOI
5 Kalicke T, Frangen TM, Muller EJ, Muhr G, Hopf F. Traumatic manubriosternal dislocation. Arch Orthop Trauma Surg 2006;126:411-6.   DOI
6 Harston A, Roberts C. Fixation of sternal fractures: a systematic review. J Trauma 2011;71:1875-9.   DOI
7 Knobloch K, Wagner S, Haasper C, Probst C, Krettek C, Otte D, et al. Sternal fractures occur most often in old cars to seat-belted drivers without any airbag often with concomitant spinal injuries: clinical findings and technical collision variables among 42,055 crash victims. Ann Thorac Surg 2006;82:444-50.   DOI
8 Divisi D, Di Leonardo G, Crisci R. Surgical management of traumatic isolated sternal fracture and manubriosternal dislocation. J Trauma Acute Care Surg 2013;75:824-9.   DOI
9 Schulz-Drost S, Oppel P, Grupp S, Schmitt S, Carbon RT, Mauerer A, et al. Surgical fixation of sternal fractures: preoperative planning and a safe surgical technique using locked titanium plates and depth limited drilling. J Vis Exp 2015;(95):e52124.
10 Gandy KL, Moulton MJ. Sternal plating to prevent malunion of transverse sternotomy in lung transplantation. Ann Thorac Surg 2008;86:1384-5.   DOI
11 Trinca GW, Dooley BJ. The effects of mandatory seat belt wearing on the mortality and pattern of injury of car occupants involved in motor vehicle crashes in Victoria. Med J Aust 1975;1:675-8.   DOI
12 Heyes FL, Vincent R. Sternal fracture: what investigations are indicated? Injury 1993;24:113-5.   DOI
13 Fabian TC, Mangiante EC, Patterson CR, Payne LW, Isaacson ML. Myocardial contusion in blunt trauma: clinical characteristics, means of diagnosis, and implications for patient management. J Trauma 1988;28:50-7.   DOI
14 Molina JE. Evaluation and operative technique to repair isolated sternal fractures. J Thorac Cardiovasc Surg 2005;130:445-8.   DOI
15 Queitsch C, Kienast B, Voigt C, Gille J, Jurgens C, Schulz AP. Treatment of posttraumatic sternal non-union with a locked sternum-osteosynthesis plate (TiFix). Injury 2011;42:44-6.   DOI
16 Byun CS, Park IH, Hwang WJ, Lee Y, Cho HM. Analysis of sternal fixation results according to plate type in sternal fracture. Korean J Thorac Cardiovasc Surg 2016;49:361-5.   DOI
17 Sadaba JR, Oswal D, Munsch CM. Management of isolated sternal fractures: determining the risk of blunt cardiac injury. Ann R Coll Surg Engl 2000;82:162-6.
18 Wu LC, Renucci JD, Song DH. Sternal nonunion: a review of current treatments and a new method of rigid fixation. Ann Plast Surg 2005;54:55-8.   DOI
19 Zhao Y, Yang Y, Gao Z, Wu W, He W, Zhao T. Treatment of traumatic sternal fractures with titanium plate internal fixation: a retrospective study. J Cardiothorac Surg 2017;12:22.   DOI
20 Athanassiadi K, Gerazounis M, Moustardas M, Metaxas E. Sternal fractures: retrospective analysis of 100 cases. World J Surg 2002;26:1243-6.   DOI
21 Klei DS, de Jong MB, Oner FC, Leenen LPH, van Wessem KJP. Current treatment and outcomes of traumatic sternal fractures-a systematic review. Int Orthop 2019;43:1455-64.   DOI
22 Collins JN, Cole FJ, Weireter LJ, Riblet JL, Britt LD. The usefulness of serum troponin levels in evaluating cardiac injury. Am Surg 2001;67:821-5; discussion 825-6.
23 Ciriaco P, Casiraghi M, Negri G, Gioia G, Carretta A, Melloni G, et al. Early surgical repair of isolated traumatic sternal fractures using a cervical plate system. J Trauma 2009;66:462-4.   DOI