Orlando Téllez-Almenares, MD, MSc
Saturnino Lora Provincial Hospital, Santiago de Cuba, Cuba; University of Medical Sciences of Santiago de Cuba, Santiago de Cuba, Cuba;
E-mail: orlandotellez.al@gmail.com
Introduction
Trauma remains a global health concern with meaningful repercussions on peoples’ lives and healthcare systems.1,2 The
development and mechanisation of industries and vehicles’ widespread use has been determining factors in increased traumas.3
The Swedish Trauma Registry informs that it is one of the leading
cause of death and disability in individuals under 45 worldwide,
surpassing cancer deaths among young adults.4
Road traffic crashes are a foremost cause of injury, posing
a critical matter in numerous nations.2
The World Health Organisation (WHO) conveyed that traffic accidents provoke approximately
1.3 million yearly casualties.5
As per National Trauma Data Bank’s
2016 annual report,6
223,866 motor vehicle accidents ensued in the
United States, resulting in 10,343 casualties. A recent Cuban report7
points out that between 2019 and 2020, there were 1,368 fatalities
from road traffic accidents, of which 80.8% were male.
Blunt trauma is a common occurrence in motor vehicle
collisions and is associated, in most cases, with severe organ damage.1,6,8 In Sweden, blunt injuries account for approximately 90%
of all injuries. Blunt thorax traumas (BTT) are the third leading
cause of trauma-related death, preceded only by traffic-related
head and abdominal injuries.8
The thorax is one of the most affected regions in motor
vehicle accidents. The 2016 National Trauma Data Bank statistics6
logged 1,29,338 thoracic traumas (TT) with AIS>3 with a fatality
rate of 9.53. Multiple authors have noted that TT mortality is approximately 25% of all traumatic deaths globally and contributes
25% to mortality from other types of traumas. South Korean research Byun et al1
shows that 33.6%-non-surviving caseload died
due to significant chest harm. In contrast, a Cuban study3
states
that TT accounts for 4-6% of trauma admissions in Cuba and has
a fatality rate of 15%.
The sternum is a peculiar, odd bone located in the anteromedial thorax region, it measures 15-20 cm in length, and as it
extends distally, its thickness gradually decreases.9
Fractures of this
bone are uncommon and can ensue in isolation or alongside other
organ damage, implying more significant morbidity and mortality.10,11 Studies Brookes et al,12 Hochhegger et al,13 Knobloch et al,14
and Bentley et al15 reveal traumatic sternal fractures (SFs) occur in
8-18% of BTT and polytrauma victims. In contrast, they are unusual in open trauma and refer that using seat belts is associated with
a higher frequency of these fractures.
These fractures arise from diverse aetiological mechanisms, some of which may provoke minor chest wall injuries,
while others can have deadly outcomes. The sternal fracture’s main
aetiological culprits are direct impact, the upper thoracic region’s
compression, and deceleration.16,17 In car crashes, the SFs are generally associate with seat belt use or the blow against the steering
wheels.17
This report aims to outline the case of a patient who suffered a traumatic SF after a traffic crash, the injury’s characteristics,
and its clinical and surgical management.
