Successful Manubriosternal Fusion Following Failure of Open Reduction and Internal Fixation of a Traumatic Manubriosternal Dislocation: A Case Report
Manubriosternal joint dislocations are rare clinical entities that may occur secondary to trauma1-4, inflammatory arthropathy5-7, or infection8. When they occur in a traumatic setting, concomitant cardiac contusions, pulmonary contusions, and spine fractures or dislocations may be observed9,10, and they must be treated appropriately. Manubriosternal dislocations may be classified as type-1 injuries, in which the sternal body is dislocated posteriorly with respect to the manubrium, or as type-2 injuries, in which the sternal body is dislocated anteriorly11. It is felt that most posterior dislocations are the result of direct impact to the anterior chest wall, while anterior dislocations are uniformly the result of an indirect flexion-compression mechanism12. Both operative1-4 and nonoperative8,10,11,13 strategies have been employed, but because of the relative rarity of this injury, a consensus regarding optimal management has not been established.