Research Abstract
Sternal fractures are rare accounting for about 3–8% of traumatic chest. There are many lines of
treatments for sternal fractures which can be classified as conservative or surgical. Surgical techniques include wire
fixation and sternal plating. There are no standardization of indications for each line of management.
We explore if sternal reconstruction using locking titanium plates and self-tapping screws provide the patient with
the best chance of proper sternal healing avoiding chronic pain and its complications and allow the patient early
mobilization and rapid restoring of his normal life at its maximum.
Methods: Our inclusion criteria are patients of both gender from 20 to 60 years of age presented with traumatic
sternal fracture at any site or pathological fracture due to metastatic or primary tumors infiltrating the sternum.
High Associated Injury Scale scores were excluded. Exclusion criteria also included patients younger than 20 years or
older than 60 years. Primary outcome is post-operative pain score and is measured using numerical pain scale
ranging from zero to 10 where zero means there is no pain at all and ten is the worst imaginable pain ever.
Results: Sternal reconstruction using titanium plates has proven to be an efficient method of stabilization with
tremendous immediate relief of pain showed by the differences between pre-operative and post-operative pain
scale scores in our patients (n = 5) with Median scores being 7 and 1.5 with range being from 7 to 9 and 1 to 3
respectively (p-value = .039). Operative time range between 150 min and 90 min with median of 120 min.
Extubation of patients was smooth with no events with median time of extubation being 120 min. From our
experience, there were no observed wound complications except at the third patient who suffered a small wound
hematoma that was resolved by gentle compressing only and needed no further intervention.
Conclusion: We recommend adopting sternal reconstruction using titanium plating systems more readily
encouraging even larger clinical trials on the way to a clear guidelines. Plating systems show promising results with
least pain, better stability, less complications and rapid, smooth recovery.
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