Spontaneous sternum fracture in a pathologic area. Case report and literature review

• Published in: Acta ortopédica mexicana Vol. 24; no. 1; pp. 33 - 36
• Main Authors: Matus Jiménez, Juan, Henríquez Avalos, Cecilia, Lorenzini González, Guillermo
• Format: Journal Article
• Language: Spanish
• Published: Mexico 01.01.2010
• Subjects: Bone Plates; Chest Pain - etiology; Follow-Up Studies; Fractures, Spontaneous - etiology; Fractures, Spontaneous - surgery; Humans; Male; Middle Aged; Multiple Myeloma - complications; Multiple Myeloma - radiotherapy; Osteolysis - diagnostic imaging; Osteolysis - etiology; Radiography, Thoracic; Sternum - surgery; Time Factors; Treatment Outcome
• ISSN: 2306-4102

A male, 62-year-old patient presented with chest pain with no apparent cause. Imaging studies revealed solution of continuity of the bone tissue at the level of the sternum, which led to paradoxical respiration. Open reduction and fixation with an LCP plate and screws were performed to address the problem. An important part of the patient's history was lumbar pain treated conservatively with analgesics and muscle relaxants. The pain did not subside and X-rays were done with findings of osteolysis in several parts of the body. The patient had chest pain and respiratory distress and was referred for management. Sternum fractures occur occasionally and are due to high-energy trauma or sports accidents. Treatment is conservative in most cases or may consist of a wire cerclage. Treatment was aimed at fixing the sternum to improve ventilatory mechanics so that the patient could continue with background therapy for multiple myeloma. At 18 weeks the patient is doing fine, X-rays show grade IV healing, and he will go on to the second stage of radiotherapy.