What Is the Breast Bone?

The sternum is a long flat bone, with its upper width and lower width, located subcutaneously in the middle of the anterior wall of the thorax. The upper and both sides of the sternum are connected to the clavicle and 7 pairs of costal cartilage, respectively. The natural position of the sternum in the human body is similar to the frontal position, slightly obliquely forward and downward, slightly convex in the front, and recessed in the back. From top to bottom, there are three parts of the sternal stalk, the sternum, and the xiphoid. The three are combined by cartilage. .

The sternum is a long flat bone, with its upper width and lower width, located subcutaneously in the middle of the anterior wall of the thorax. The upper and both sides of the sternum are connected to the clavicle and 7 pairs of costal cartilage, respectively. The natural position of the sternum in the human body is similar to the frontal position, slightly obliquely forward and downward, slightly convex in the front, and recessed in the back. From top to bottom, there are three parts of the sternal stalk, the sternum, and the xiphoid. The three are combined by cartilage. .

Chinese name

sternum

Foreign name

sternum

Pinyin

xing g

Zhuyin

¨Ò eng

Sternum I. Overview:

There are three notches on the upper edge of the sternal stem, and a shallow and wide jugular vein notch in the middle; there are clavicle notches on the two sides of the oval-shaped articular surface, forming joints with the sternal end of the clavicle. There are 7 pairs of costal notches on both sides of the sternal stem and the sternum body, which are connected to the first to seventh pair of costal cartilages, respectively.

The raised deformity is called "chicken breast" and the recessed deformity is called "funnel chest". Both malformations are usually caused by a lack of vitamin D and calcium. Clinically, sternal bone marrow is used for examination.

Sternal 2. Related diseases and treatment

1. The sternal fracture is caused by the strong force acting directly on the sternum, such as car impact, heavy object crushing, blunt impact, and severe spinal flexion. Simple sternal fractures are not severely fatal, and the serious adverse consequences are mainly caused by severe combined injuries. Violence on the front chest often leads to severe chest organ damage such as constriction of large vessels of the heart, multiple rib fractures, pulmonary contusion, bronchial rupture, etc., and even abdominal organ damage, prone to hemorrhagic shock, flail chest , Respiratory dysfunction and other serious life-threatening complications. Therefore, the diagnosis and emergency treatment of combined injuries are very important. First, deal with life-threatening concurrent injuries, such as hemorrhagic shock, cardiac tamponade, tension pneumothorax, active hemothorax, and craniocerebral and abdominal organ damage. Consider treating sternal fractures.

2. The sternal fractures are most common in sternal fractures, accounting for 76.5%, followed by sternal fractures, accounting for 9%, and sternal fractures and body junction fractures, accounting for 8.5%.

. Sternal 3. Inspection method:

3.1 Chest X-ray: it is the preferred imaging method for diagnosing sternal fractures. Sternal fractures often occur lateral and oblique displacements, which can be diagnosed by plain radiographs of the lateral and posterior anterior oblique positions. However, plain radiographs detect linear fractures and incomplete fractures with no displacement at the stump. The output rate is low, and the body position is strict. Patients with severe injuries often cannot cooperate with standard body posture due to pain or severe compound injuries, which affects image quality and diagnostic accuracy, and easily leads to missed diagnosis.

3.2 Ultrasound: Ultrasound has high sensitivity and specificity in diagnosing sternal fractures. It can accurately observe small fracture lines and can detect some comorbidities in the chest, such as mediastinal hematoma and pleural effusion. Compared with the emergency department, but the ultrasound is not accurate in determining the extent of fracture displacement, and the observation of changes in the lungs, thoracolumbar spine, and ribs is limited, which limits its further application.

3.3 CT examination: CT, especially multi-slice spiral CT, can provide narrower collimator width, faster volume scanning speed, higher density resolution and spatial resolution, and can simultaneously display lung tissue, the entire chest cavity, and the mediastinum And changes in the vertebral body. The CT scan can also observe changes in the sternum and its surrounding organs. It has incomparable advantages for examining sternal fractures. However, misdiagnosis also occurs in conventional CT axial diagnosis, and most of them are horizontal fractures without displacement. MPR technology can observe the situation of sternal fractures from any orientation and at any level. The detection of sternal fractures is more accurate, especially for transverse and fractures without separation displacement, which is more sensitive than conventional CT, which makes up for the lack of axial CT examination. Provide more accurate and comprehensive imaging basis for clinical diagnosis and further treatment.

3.4 Imaging diagnosis: According to X-ray chest lateral and oblique radiographs, it is found that the sternal bone is displaced and the cortical rupture can be diagnosed. CT examination can clearly observe the position of the fracture and the displacement of the stump, which can accurately diagnose. Clinically, when the patient has a serious history of chest trauma and cannot describe chest pain, the sternal condition should be observed, and if necessary, MPR image reconstruction technology should be used to confirm the diagnosis. Once missed diagnosis, the patient's failure to receive surgical treatment in a timely manner can cause long-term sternum pain and dysfunction, and complex injuries caused by severe sternal fractures can easily lead to life-threatening patients. Therefore, timely and accurate diagnosis is particularly critical for clinical treatment.

The fixation methods for sternal fractures are steel wire fixation, memory alloy sternal fixator fixation, and titanium plate fixation. The traditional sternal fixation method is fixed with non-embroidered steel wire. For those who do not enter the thoracic, the surgical space behind the sternum is small, it is difficult to thread the lead wire, and it is necessary to free the periosteum before and after the sternum, which will affect the sternum blood supply. In addition, the stability of the sternum fixed by the wire is poor, the wire is broken or displaced, and the longitudinal tension of the wire pulls the cutting tension of the sternum. The effect is not good when the fracture is broken or comminuted. The nickel-titanium memory alloy sternal embracing fixture is used to hug the sternum between the upper and lower ribs. The fixation effect is reliable. After the temperature is restored, the original shape is not necessarily fitted to the sternum. The upper and lower periosteal and intercostal concavity of the fracture need to be free, and the metal body is large, which easily causes the sternal anterior tissue to bulge. The experience of using titanium plate to fix the sternum is as follows: (1) the operation is convenient and safe, the operation time is short, the amount of bleeding is small, and no drainage is required; (2) the sternum is stable after surgery and no sternal displacement occurs; (3) the operation He recovered quickly, his breathing improved significantly, and his pain improved significantly.