PMC10360415_01
Three-dimensional reconstruction of chest CT showing oblique fracture through a congenitally fused sternum.
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F1
He was found to have an acute, displaced sternal body fracture with associated mediastinal hematoma superimposed on a congenitally fused sternum and manubrium with sternal foramen and bifid xiphoid process (figure 1).
PMC10360415_02
PMC10360415_03
Intraoperative photo of 26-hole ladder plate securing reduction of the sternal fracture.
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F2
While our typical practice with sternal fractures is to achieve stability through longitudinal plates placed in "railroad track" fashion, given his congenitally fused sternum and the fracture characteristics, we elected to place a 26-hole ladder sternal plate using unicortical screws (figure 2).
Postoperative chest radiograph showing plate placement and small left apical pneumothorax.
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F3
His left pneumothorax resolved without intervention (figure 3).