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. 2005 Dec;29(6):339-42.
doi: 10.1007/s00264-005-0001-y. Epub 2005 Aug 5.

Vertebral fractures and concomitant fractures of the sternum

Mihai H Vioreanu  1 , John F Quinlan, Ian Robertson, John M O'Byrne
Affiliations

Vertebral fractures and concomitant fractures of the sternum

Mihai H Vioreanu et al. Int Orthop. 2005 Dec.

Abstract
in English, French

From October 1996 to August 2001, 721 patients with vertebral fractures were admitted to our unit. Ten patients suffered from vertebral fractures and concomitant sternal fractures. The clinical notes and plain film radiographs of these patients were studied. The average age of the patients was 37 (20-69) years. Nine had been involved in road traffic accidents. Three patients had fractures of the cervical spine, six of the upper thoracic spine (T1-T6) and one had a lumbar spine fracture. The extra-thoracic fracture group included two patients with neurological compromise and two patients who were neurologically intact. The entire upper thoracic fracture group suffered neurological compromise, with four patients suffering complete neurological deficit. In addition, four of these patients suffered potentially life-threatening intra-thoracic injuries. The relative severity of the neurological compromise and the attendant injuries in the upper thoracic fracture group offers compelling evidence in support of the "fourth column" theory, as expressed by Berg [Berg EE (1993), The sternal-rib complex. A possible fourth column in thoracic spine fractures. Spine 18(13):1916-1919].

D'octobre 1996 à août 2001, 721 malades avec une fracture vertébrale ont été admis dans notre unité. Dix malades ont souffert de fractures vertébrales et de fractures sternales concomitantes. Les observations et les radiographies de ces malades ont été étudiés. L'âge moyen était de 37 ans (20–69). Neuf avaient été impliqués dans des accidents de la circulation. Trois malades avaient des fractures de la colonne cervicale, six de la colonne thoracique supérieure (T1–T6) et un avait une fracture de la colonne lombaire. Le groupe des fractures extra thoraciques a inclus deux malades avec atteinte neurologique et deux sans atteinte neurologique. Il y a toujours eu une atteinte neurologique dans le groupe des fractures thoraciques supérieures , avec quatre malades qui souffrent d'un déficit neurologique complet. En plus, quatre de ces malades avaient des blessures intra-thoraciques potentiellement mortelles. La sévérité relative de l'atteinte neurologique et les lésions associées dans le groupe des fractures thoraciques supérieures appuient la “théorie de la 4e colonne” comme exprimée par Berg (Berg EE (1993) The sternal-rib complex. A possible fourth column in thoracic spine fractures. Spine 18(13):1916–1919).

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