Surgical Sternal Fixation versus Conservative Management in Patients with Traumatic Fracture Sternum | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 156, Volume 100, Issue 1, July 2025, Page 3635-3639 PDF (688.89 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2025.447685 | ||||
 View on SCiNiTO | ||||
| Abstract | ||||
| Background: Traumatic sternal fractures, though uncommon, can lead to significant morbidity and mortality. Management strategies vary between conservative approaches and open surgical sternal fixation, with no established guidelines to recommend one over the other. Objective: This study aimed to compare the outcomes of surgical sternal fixation versus conservative management modalities. Methods: A retrospective analysis was conducted on 87 patients admitted with traumatic sternal fractures from January 2016 to October 2024. Propensity matching resulted in two comparable groups of patients, 36 patients in each group, those managed conservatively and those undergoing surgical sternal fixation. The primary result measured was mortality, while secondary results included hospital stay, intensive care unit stay, ventilation duration & in-hospital complications. Results: Surgical fixation was associated with significantly lower mortality (2.8% vs. 13.9%, p = 0.11). However, the surgical group had longer hospital and ICU stays (p < 0.001). Ventilation duration and complication rates, including acute respiratory distress syndrome (ARDS), pneumonia, and myocardial infarction (MI), were comparable between groups. Patients in the non-surgical group reported more severe pain levels on numeric pain scale (25.0% vs. 11.1%, p = 0.126), though this difference was not statistically significant. Conclusion: Surgical sternal fixation demonstrated a clear advantage in reducing mortality and potentially improving pain outcomes in cases of traumatic sternal fractures involving instability or displacement. Conservative management remains effective for less severe injuries. | ||||
| Keywords | ||||
| Conservative management; Polytrauma; Sternal fracture; Surgical sternal fixation | ||||
|
Statistics Article View: 10 PDF Download: 10 |
||||
