OCCULT MANUBRIOSTERNAL JOINT INJURY ASSOCIATED WITH FRACTURE OF THE THORACIC SPINE

New reduction technique simplified for surgical stabilisation of isolated manubriosternal dislocation: A case report and literature review

Manubriosternal joint (MSJ) dislocation is often poorly tolerated, with pain, and both static and dynamic dysfunction in breathing. This injury is rare, and treatment includes both surgical and non-surgical interventions. Moreover, the treatment needs to be personalised to a specific case. We present a case of a 19-year-old Comorian man who had chest pains that were exacerbated by movements after falling from a tree. Careful physical examination revealed that the man had a ‘stair step’-looking deformity located at the anterior chest wall at the level of the MSJ. A computed tomography scan confirmed the diagnosis of manubriosternal disruption. The patient underwent a surgical intervention under general anaesthesia and had an uneventful recovery.

Manubriosternal dislocation type II associated with thoracic spine fracture: What can we learn from this?

Traumatic dislocation of the manubriosternal joint is rare, and management correction requires an individualised decision. We report a case of a young female who suffered a type II manubriosternal dislocation with concomitant thoracic spine fracture, as a result of a motor vehicle accident. The mechanism and various therapeutic outcomes are discussed, and a review of the literature provided.

Missed manubriosternal dislocation in patient with thoracolumbar fracture, a case report

Background

Spine fractures combined with sternal injury are most commonly occur in the thoracic region. Lower cervical and thoracolumbar injuries have also been reported, especially for the patients with manubriosternal dislocation. The type of spine injury is easily recognized in initial presentation, but we may miss the sternal fracture and manubriosternal dislocation.

Case presentation

A 23-year-old male patient complained with chest, right ankle, and lumbar pain after a fall at ground level, with diagnosis of right distal tibial fracture, sternal fracture, calcaneus fracture, and L2 vertebral fracture. However, neurologically he was completely normal. He underwent the operation for his lower extremity and spine, but we missed his manubriosternal dislocation after discharged. After one month, he came to the clinic with complained of chest pain, the imaging exams showed anterior dislocation of manubriosternal joint. We chose conservative treatment for manubriosternal dislocation. He was followed up at monthly intervals and radiographs along with computerized tomography showed satisfactory in fracture healing of lumber and the sternal fracture. However, the manubriosternal dislocation was malunioned. The patient had appearance deformity of the manubriosternal joint.

Conclusion

This case supports the concept of the existence and clinical relevance of the thoracic cage theory, the thoracolumbar vertebrae should also be included in the thoracic cage theory.