Polish Journal of Thoracic and Cardiovascular Surgery
eISSN: 1897-4252
ISSN: 1731-5530
Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery
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1/2026
vol. 23
 
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abstract:
Review paper

Operative management of unstable sternal fracture in polytrauma: a case report and literature review

Chrysa Andrikopoulou
1
,
Edvin Selmani
2
,
Vasileios Leivaditis
3
,
Panagiotis Antzoulas
4
,
Konstantinos Tasios
5
,
Elias Liolis
6
,
Andreas Antzoulas
7
,
Dimitrios Litsas
8
,
Panagiotis Dimitrios Papadopoulos
9
,
George Theofanis
7
,
Konstantinos Nikolakopoulos
10
,
Ioannis Panagiotopoulos
11
,
Dimitrios Schizas
12
,
Efstratios Koletsis
13
,
Sofoklis Mitsos
14
,
Periklis Tomos
14
,
Agron Dogjani
2
,
Francesk Mulita
1, 7

  1. Department of General Surgery, General Hospital of Eastern Achaia – Unit of Aigio, Aigio, Greece
  2. Department of Surgery, University of Medicine of Tirana, Albania
  3. Department of Cardiothoracic and Vascular Surgery, Westpfalz Klinikum, Kaiserslautern, Germany
  4. Department of Orthopedics, General University Hospital of Patras, Greece
  5. John Radcliffe Hospital Emergency Department, University Hospitals NHS Foundation Trust, Headley Way, Headington, Oxford, UK
  6. Department of Oncology, General University Hospital of Patras, Greece
  7. Department of Surgery, General University Hospital of Patras, Greece
  8. Department of Surgery, General Hospital of Lamia, Greece
  9. Department of Surgery, Spital Herisau, Appenzell Ausserrhoden, Switzerland
  10. Department of Vascular Surgery, General University Hospital of Patras, Greece
  11. Division of Cardiac Surgery, Hippokration General Hospital of Athens, Greece
  12. First Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Greece
  13. Department of Thoracic Surgery, Attikon General Hospital, National and Kapodistrian University of Athens, Greece
  14. Department of Cardiothoracic Surgery, General University Hospital of Patras, Greece
Kardiochirurgia i Torakochirurgia Polska 2026; 23 (1): 56–63
DOI: https://doi.org/10.5114/kitp.2026.160556
Online publish date: 2026/04/04
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Sternal fractures are uncommon but clinically relevant injuries, most often resulting from blunt thoracic trauma in motor vehicle collisions. While most isolated fractures can be treated conservatively, surgical stabilisation may be required in cases of displacement, instability, or polytrauma. Modern plating techniques offer biomechanical advantages over traditional wire fixation, but indications remain variably defined. We report the case of a 33-year-old male polytrauma patient involved in a high-impact motor vehicle accident. He sustained a displaced sternal fracture with manubriosternal dislocation, bilateral rib fractures (right 4th–8th, left 6th–7th), flail chest, pulmonary contusion, a retrosternal haematoma, and left hip dislocation. Surgical management included open reduction and internal fixation of the sternum with 2 titanium plates, haematoma evacuation, and orthopaedic intervention. The postoperative course was initially uneventful; however, the patient was readmitted 1 month later with a surgical site infection caused by Proteus mirabilis.
keywords:

vacuum-assisted closure therapy, thoracic trauma, polytrauma, sternal fracture, surgical fixation, titanium plating
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