Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2023; 11(30): 7386-7392
Published online Oct 26, 2023. doi: 10.12998/wjcc.v11.i30.7386
Using shape-memory alloy staples to treat comminuted manubrium sterni fractures: A case report
Min Zhang, Wei Jiang, Ze-Xue Wang, Zhi-Ming Zhou
Min Zhang, Wei Jiang, Ze-Xue Wang, Zhi-Ming Zhou, Department of Thoracic Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang 110024, Liaoning Province, China
Author contributions: Zhang M wrote and revised the article, Wang ZX reviewed the medical records, Jiang W conducted the literature review and Zhou ZM revised the article; all authors have read and approved the final version to be submitted.
Supported by Shenyang Medical College Youth Scientific Research Fund, No. 20202027.
Informed consent statement: Informed written consent was obtained from the patient to publish this case report and accompanying images.
Conflict-of-interest statement: All the authors have no conflicts of interest relevant to this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Ming Zhou, MD, Professor, Department of Thoracic Surgery, Central Hospital Affiliated to Shenyang Medical College, No. 5 South Seventh West Road, Tiexi District, Shenyang 110024, Liaoning Province, China. thoracicsurgery123@163.com
Received: August 15, 2023
Peer-review started: August 15, 2023
First decision: September 13, 2023
Revised: September 22, 2023
Accepted: October 8, 2023
Article in press: October 8, 2023
Published online: October 26, 2023
Abstract
BACKGROUND

Comminuted manubrium sterni fractures are rare, and internal fixation methods are limited. This report explored a practical and feasible method of internal fixation for comminuted manubrium sterni fractures.

CASE SUMMARY

A 17-year-old female was injured in a car accident for which she underwent debridement and suturing of her head and anterior chest wounds in another hospital. Eight days later, the patient was transferred to our hospital for surgical treatment. The manubrium sterni was found intraoperatively to be split into three irregular fragments with obvious overlap and separation displacement. Meanwhile, a manubriosternal joint dislocation and left first rib cartilage fracture were observed. The retraction force of the shape-memory alloy staples was used to pull the fracture fragments together. Two more titanium locking plates were then used to fix the manubrium sterni and corpus sterni longitudinally, and the left first rib cartilage fracture was repositioned and fixed with a titanium locking plate. A postoperative computed tomography scan showed reduced and rigid fixation of the comminuted manubrium sterni fractures. The patient recovered well with no significant complaints of discomfort. The patient was discharged 10 days postoperatively after the stitches had been removed.

CONCLUSION

Shape-memory alloy staples had the advantage of being safe and effective during the repositioning and internal fixation of comminuted manubrium sterni fractures. Therefore, they provided a new surgical option for comminuted manubrium sterni fractures.

Keywords: Shape-memory alloy staples, Fracture fixation, Manubrium sterni, Internal fixation, Manubriosternal joint dislocation, Case report

Core Tip: Manubrium sterni fractures are rare. Plate osteosynthesis is usually used for unstable transverse and oblique fractures. However, the surgical approach for comminuted manubrium sterni fractures has yet to be reported in the literature. In this case, comminuted manubrium sterni fractures, manubriosternal joint dislocation, and a left first rib cartilage fracture co-occurred in the patient. A creative attempt was made to use shape-memory alloy staples for repositioning and primary fixation of the manubrium sterni fragments. A postoperative computed tomography scan showed reduced and rigid fixation of the comminuted manubrium sterni fractures. This successful attempt provides a new solution for comminuted manubrium sterni fractures.