• Dorine S Klei, F Cumhur Öner, LeenenLuke P HLPHDepartment of Trauma Surgery, Medical Centre Utrecht, University, Suite G04.232, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands., and van WessemKarlijn J PKJPDepartment of Trauma Surgery, Medical Centre Utrecht, University, Suite G04.232, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands..
• Department of Trauma Surgery, Medical Centre Utrecht, University, Suite G04.232, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands. d.s.klei@umcutrecht.nl.
• Eur J Trauma Emerg Surg. 2021 Aug 1; 47 (4): 9911001991-1001.

PurposeCombined sternal and spinal fractures are rare traumatic injuries with significant risk of spinal and thoracic wall instability. Controversy remains with regard to treatment strategies and the biomechanical need for sternal fixation to achieve spinal healing. The present study aimed to assess outcomes of sternovertebral fracture treatment.MethodsA systematic review of literature on the treatment of traumatic sternovertebral fractures was conducted. Original studies published after 1990, reporting sternal and spinal healing or stability were included. Studies not reporting treatment outcomes were excluded.ResultsSix studies were included in this review, with a total study population of 98 patients: 2 case series, 3 case reports, and 1 retrospective cohort study. 10 per cent of sternal fractures showed displacement. Most spinal fractures were located in the thoracic spine and were AOSpine type A (51%), type B (35%), or type C (14%). 14 per cent of sternal fractures and 49% of spinal fractures were surgically treated. Sternal treatment failure occurred in 5% of patients and biomechanical spinal failure in 8%. There were no differences in treatment failure between conservative and operative treatment.ConclusionLiterature on traumatic sternovertebral fracture treatment is sparse. Findings indicate that in most patients, sternal fixation is not required to achieve sternal and spinal stability. However, results of the current review should be cautiously interpreted, since most included studies were of poor quality.© 2020. The Author(s).

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