A new technique for intramedullary screw fixation of sternal fractures.

Abstract

Sternal fractures are uncommon but may result in significant morbidity when associated with respiratory compromise or severe pain. Conventional methods such as plate fixation are often invasive and technically challenging. We retrospectively reviewed eight cases of transverse sternal fractures treated using an intramedullary fixation technique with cannulated cancellous screws (CCS). Preoperative computed tomography with 3D reconstruction was used for surgical planning. Reduction was achieved percutaneously or through a limited incision, followed by guidewire insertion and screw fixation. The minimally invasive procedure was completed in 18-35 min (mean, 22 min) with little blood loss (mean, 23 mL). Among six patients with ventilatory compromise, four were successfully extubated within three days postoperatively. There were no complications related to screw insertion, and bone union was confirmed in all cases. Intramedullary screw fixation represents a safe, minimally invasive, and mechanically robust alternative for the management of sternal fractures, particularly in patients with flail chest or severe pain.