Manubriosternal dislocation caused by indirect flexion-compression trauma

Manubriosternal dislocation caused by indirect flexion-compression trauma i s an extremely rare condition. Two forms of manubriosternal luxation are di stinguished: in type I the sternum is dislocated posterior and in type II a nterior to the manubrium. Direct or indirect trauma may cause manubriostern al dislocation. Mode of injury in direct trauma is mostly a head-on colliti on in a motor accident resulting either in type I or type II luxation. The unusual origin of manubriosternal dislocation by indirect trauma is put dow n to flexion-compression injuries of the thoracic spine and results in a ty pe II dislocation. Predisposition to manubriosternal dislocation by indirec t trauma consists in rheumatoid arthritis or extreme forms of kyphosis. Out come of many patients treated conservatively after initial reposition with adhesive tape, symptomatic pain therapy, cryotherapy and prohibition of any physical training over several weeks is subluxation or complete luxation o f the manubriosternal joint. This condition may lead to chronic pain, peria rticular calcification with ankylosis and progredient deformation. Lacking a controlled study for treatment of manubriosternal dislocation a standard therapeutic regime could not be established yet. In the literature only a f ew case-reports of patients undergoing operative therapy are published. We report a type II dislocation of the manubriosternal joint caused by indirec t flexion-compression trauma. We achieved a very good long-term result usin g a 8-hole 1/3 tubular plate for fixation of the manubriosternal joint afte r reposition.