Thorac cardiovasc Surg 2017; 65(07): 551-559
DOI: 10.1055/s-0037-1598194
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Concomitant Sternal Fracture in Flail Chest: An Analysis of 21,741 Polytrauma Patients from the TraumaRegister DGU®

Stefan Schulz-Drost1, Sebastian Krinner1, Andreas Langenbach1, Pascal Oppel1, Rolf Lefering2, Dominic Taylor3, Friedrich F. Hennig1, Andreas Mauerer3, the TraumaRegister DGU, 4
  • 1Department of Trauma and Orthopedic Surgery, University Hospital Erlangen, Erlangen, Germany
  • 2Institute for Research in Operative Medicine (IFOM), University of Witten/Herdecke, Cologne Merheim Medical Center (CMMC), Cologne, Germany
  • 3Department of Orthopedic and Trauma Surgery, St. Theresien Krankenhaus, Nuremberg, Germany
  • 4Committee on Emergency Medicine, Intensive Care and Trauma Management (Sektion NIS) of the German Trauma Society (DGU)
Further Information

Publication History

15 October 2016

28 December 2016

Publication Date:
10 February 2017 (eFirst)


Background Isolated sternal fractures (SFs) rarely show complications, but their influence in a thorax trauma of the seriously injured still remains unclear.

Methods A retrospective analysis of the TraumaRegister DGU® was performed involving the years 2009 to 2013 (Injury Severity Score [ISS] ≥ 16, primary admission to a trauma center). Cohort formation: Unilateral and bilateral flail chest (FC) injuries with and without a concomitant SF, respectively.

Results In total, 21,741 patients (25% female) met the inclusion criteria, with 3,492 (16.1%) showing SF. Unilateral FC patients were on average 53.6 ± 18.4 years old, and bilateral FC patients were on average 55.2 ± 17.7 years old. The ISS in unilateral FC and bilateral FC amounted to 31.2 ± 13.0 and 43.4 ± 13.1 points, respectively. FC with an SF occurred more frequently as an injury to car occupants and less frequently as an injury to motorcyclists or in injuries due to falls.

Conclusion Patients with an SF additional to an FC had longer hospital and intensive care unit stays and were longer artificially respirated than those patients without an SF. SF indicates possible cardiac and thoracic spine injuries.