韩国单中心治疗创伤性胸骨骨折十年的经验:回顾性队列研究

N. Lee, Seon Hee Kim, Jae Hun Kim, Hohyun Kim, Sang Bong Lee, C. Park, G. Kim, Dongyeon Ryu, Sun Hyun Kim
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引用次数: 0

摘要

目的:目前缺乏有关胸骨骨折治疗效果的临床报告。本研究详细介绍了一家医疗机构 10 年来与创伤性胸骨骨折相关的临床特征、治疗方法和疗效。方法:回顾性队列研究对 2012 年 1 月至 2021 年 12 月期间在一家地区创伤中心住院的患者进行了回顾性队列研究。在 7918 名胸部受伤患者中,有 266 人被诊断为创伤性胸骨骨折。收集的患者数据包括人口统计学、受伤机制、严重程度、相关损伤、胸骨骨折特征、住院时间、死亡率、呼吸系统并发症和手术细节。手术适应症包括涉及胸内损伤、不稳定骨折、严重脱位、胸部外翻、骨折愈合不良和持续性剧烈疼痛的急诊病例。结果:266名胸骨外伤性骨折患者中有260人接受了手术治疗,其中98人接受了胸骨骨折手术治疗,162人接受了保守治疗。手术指征包括胸腔内器官或血管损伤,需要进行开胸手术,以及不稳定骨折和严重脱位。影响手术治疗的因素包括外翻运动和肋骨骨折。非手术组在重症监护室的中位住院时间为5.4天(四分位距[IQR]为1.5-18.0天),手术组为8.6天(四分位距[IQR]为3.3-23.6天)。非手术组的住院时间中位数为 20.9 天(IQR,9.3-48.3 天),手术组为 27.5 天(IQR,17.0-58.0 天)。组间差异无统计学意义。手术干预非常成功,骨结合稳定,并发症极少。肋骨骨折时的畸形运动是手术干预的重要考虑因素。结论胸骨骨折的手术治疗建议因胸廓外翻、移位程度和肋骨骨折而异。对于伴有肋骨和胸骨节段性骨折的偏移型胸骨骨折患者,建议进行手术治疗。手术治疗可使骨结合稳定,并发症极少。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A decade of treating traumatic sternal fractures in a single-center experience in Korea: a retrospective cohort study
Purpose: Clinical reports on treatment outcomes of sternal fractures are lacking. This study details the clinical features, treatment approaches, and outcomes related to traumatic sternal fractures over a 10-year period at a single institution. Methods: A retrospective cohort study was conducted of patients admitted to a regional trauma center between January 2012 and December 2021. Among 7,918 patients with chest injuries, 266 were diagnosed with traumatic sternal fractures. Patient data were collected, including demographics, injury mechanisms, severity, associated injuries, sternal fracture characteristics, hospital stay duration, mortality, respiratory complications, and surgical details. Surgical indications encom-passed emergency cases involving intrathoracic injuries, unstable fractures, severe dislocations, flail chest, malunion, and persistent high-grade pain. Results: Of 266 patients with traumatic sternal fractures, 260 were included; 98 underwent surgical treatment for sternal fractures, while 162 were managed conservatively. Surgical indications ranged from intrathoracic organ or blood vessel injuries necessitating thoracotomy to unstable fractures with severe dislocations. Factors influencing surgical treatment included flail motion and rib fracture. The median length of intensive care unit stay was 5.4 days (interquartile range [IQR], 1.5–18.0 days) for the nonsurgery group and 8.6 days (IQR, 3.3–23.6 days) for the surgery group. The median length of hospital stay was 20.9 days (IQR, 9.3–48.3 days) for the nonsurgery group and 27.5 days (IQR, 17.0 to 58.0 days) for the surgery group. The between-group differences were not statistically significant. Surgical interventions were successful, with stable bone union and minimal complications. Flail motion in the presence of rib fracture was a crucial consideration for surgical intervention. Conclusions: Surgical treatment recommendations for sternal fractures vary based on flail chest presence, displacement degree, and rib fracture. Surgery is recommended for patients with off-set-type sternal fractures with rib and segmental sternal fractures. Surgical intervention led to stable bone union and minimal complications.
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