For the first time broken sternum was mentioned in the medical literature in 1864. Then we wrote about him as a pretty rare injury. Since then, thanks to the widespread dissemination of cars, broken sternum has become much more frequent injuries.
The most common cause of fracture of the sternum are road traffic accidents; in some cases it becomes a direct cause of the seat belt (but do not give up its use - it can save from much more serious injuries.
Symptoms
In typical cases, people experience pain immediately after the fracture occurred. Often the pain is acute and severe, and may be aggravated by deep breathing, coughing, laughing and / or sneezing. In addition, the pain may become stronger when to go or touch the fracture site. Some patients experience pain in other parts of the body.
In severe displaced fractures of the sternum there is an obvious deformity of the chest
Deformation of the chest: congenital and acquired - What is the danger?
.
Diagnosis and treatment
Before starting the treatment of fractures of the sternum, the patient should undergo a thorough examination. During the diagnosis is necessary not only to determine the type and severity of the fracture of the sternum, but also to identify possible damage to internal organs, particularly the lungs and heart. To assess the condition of bone tissue making radiographs. To get a detailed view of the soft tissue in the area of the fracture, used computed tomography and magnetic resonance imaging.
If damage vital organs, doctors in the first place will be engaged in the stabilization of the patient's condition. If significant damage to internal organs, and there are no detected unbiased closed fracture, the treatment may be sufficient rest and pain medication. Doctors also recommend the implementation of special breathing exercises to prevent lung collapse.
In more severe cases, such as displaced fracture of the sternum, it is necessary surgery.
Regardless of the method of treatment, patients in a period of time to avoid any activity that is accompanied by an increase in load on the sternum and increased pain.
Treatment can take anywhere from several weeks to several months. When the bones grow together sufficiently, the patient should start doing the exercises, which will help restore muscle strength and flexibility. Exercises should be performed in accordance with the recommendations of the physiotherapist.
Generally, patients who have had a fracture of the sternum, it is possible to fully recover, regardless of the severity of the fracture. The probability of serious and long-term complications is present, but they are not usually associated with a fracture, and damage to internal organs.
The structure of the sternum
Breastbone with the ribs attached thereto forms the front surface of the chest. It is a flat bone, consisting of three parts: the upper part - the handle, the middle - and lower body - xiphoid process. In adults, the three parts of the bones are fused into a single bone.
Leather - the widest and thickest part of the breast bone. In its upper part is the jugular notch, the sides of which are two clavicular notch - places of articulation with the collarbone. Below clavicular notch located recess rough cartilage ribs and I half frame, which combines with a half cutting on the body of the sternum, rib forms a complete clipping to connect to rib cartilage II. At the junction of the handle to the body of the sternum forms a small angle of the sternum facing anteriorly (it can be felt through the skin).
The body of the sternum - the longest part of the sternum, the edges of which are fin clippings to form connections with the cartilage of the ribs. Rib loin ribs to VII is located between the body of the sternum and the xiphoid process. Xiphoid process can take various forms, sometimes forked down or has a hole.
Isolated fractures of the sternum
Sternal fractures are most often the result of traffic injuries, falls or hitting a hard object. They arise at the interface of the handle and the body and at the base of the xiphoid process. This produces irregular fragments which are displaced relative to each other.
A sign of fracture is pain at the site of damage and in varying degrees of severity respiratory distress and cardiac activity. Pain increases with palpation, coughing and deep breath, there is a deformation of bone and soft tissue swelling in the area of the fracture. At the site of the fracture or fractures of the sternum often formed a hematoma (bruise). At displacement of bone fragments lower yielding fragment is often moved to front and upwards. Change the position of the victim from a prone position to a sitting position, or vice versa is accompanied by severe pain in the injured area of the sternum.
In adults, sternal fractures are often accompanied by a picture of shock. Shock - a dramatic sudden disorder neurohumoral regulation caused by mechanical action, burns and so on. It is manifested by a sharp decrease in blood supply to the tissues and inhibition of all body functions. First (immediately after the injury) shows sharp shock excitation with motor and speech activity and the lack of criticism to the state and to the environment. At this point, the victim will have high blood pressure
Blood pressure - dangerous if his swing?
Accelerated heart rate and respiratory rate. In severe trauma the state of excitation is quickly replaced by inhibition: the sufferer is pale, motionless, blood pressure is lowered, the pulse frequent, breathing part of the surface. This is a very dangerous condition, which can result in death of the victim, so it requires emergency care.
Isolated damage to the sternum in children occur more easily than adults, since it is usually not accompanied by a state of shock. This is due to the fact that the sternum in children is generally not the medullary canal, and for the most part consists of cartilage (especially in children under 7 years of age). The older the child, the harder his sternum fractures occur.
Treatment of isolated fractures of the sternum
Diagnosis closed isolated fracture of the sternum can only be made after a thorough examination, no damage to other bones of the skeleton and internal organs of the chest. X-ray examination is carried out, whose main task is to find out not only the state of the sternum and the ribs, spine and internal organs. When X-ray is determined by the displacement of bone fragments, which can be seen clearly on the side of the chest images.
If you suspect a broken sternum suffered impose a pressure bandage on the chest in a semi-sitting position and transported to the hospital. If you suspect a traumatic shock this victim can be given to take any painkillers and sedatives (analgin, pentalgin, validol
Validol - old, but reliable
, Valerian and so on). If the victim has signs of shock, he should be given medical care in the ICU.
If an inspection reveals that the fragments are not displaced sternum affected injected anesthetics, and the sternum is applied an adhesive plaster (for two weeks), prevents the removal of bone fragments. Recommended bed rest (only lie on hard surfaces) for 2-3 weeks.
By moving their fragments reduce a closed method, with the help of a special provision of the victim. If it can not straighten fragments, then held them open reduction by surgery, followed by fixation of bone fragments by means of metal constructions, which are removed after the fusion of the bones.
In most cases, the outcome of the fracture of the sternum favorable.
Galina Romanenko
