Thoracoscopy-assisted Minimally Invasive Osteosynthesis for Sternal Body Fracture Repair Utilizing a Titanium Locking Plate - A Case Report

Sep 30, 2026

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Case report and surgical rationale for thoracoscopic-assisted minimally invasive osteosynthesis of a sternal body fracture using a titanium locking plate. A 31-year-old man with persistent chest pain and a displaced sternal body fracture underwent video-assisted thoracoscopic surgery with retro-sternal dissection and fracture reduction using a dual-plate railroad technique, ensuring posterior cortex screw safety. Postoperative recovery was uneventful, with significant pain relief by 6 weeks and no pneumothorax or complications at 6 months. The case highlights rigid fixation and improved recovery.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages6

Reading Time15 min

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Introduction

Case Report

Conclusion

Keywords

Case Report Journal of Orthopaedic Case Reports 2025 December:15( 12) :Page 21-26 Thoracoscopy-assisted Minimally Invasive Osteosynthesis for Sternal Body Fracture Repair Utilizing a Titanium Locking Plate: A Case Report Deepak D Chitragar1, Sathish Devadoss1, Annamalai Devadoss1, Meenatchi Sundaram1, Ratheesh Elangovan1 Learning Point of the Article: When planning surgical fixation for a sternal body fracture, the incorporation of thoracoscopic assistance can be advantageous. A low-profile yetrobust titanium lockingplate canbe utilized ina railroad techniquefor the fixation of transversefractures. The novel technique of fixation. Abstract Introduction: Sternal fracture is a common complication of chest trauma but has a low incidence. Various treatments have been developed toreconstruct sternal fractures. Among these approaches, analgesia, corset fixation, and open reduction with wiring or plate internal fixation have been suggested. The use ofnewly developed minimally invasive plate osteosynthesis is a feasible method. In this study, wereporta case involving a 31-year-old young man with a sternal fracture accompanied by a small amount of lung contusion. All procedures including retro-sternal dissection and fracture reduction with placement of the dual plate as railroad technique were performed using video-assisted thoracoscopic surgery. The minimally invasive thoracoscopic techniqueprovided effective repair and rigid fixation with immediate relief from intractable chest pain that had persisted before surgery. The postoperative recovery was good. No pneumothorax or complications such as chest pain, paresthesia, or wound infection were observed at the 6-month follow-up visit. This case describes a novel method for internal fixation of sternal fractures under thoracoscopic assistance. Case Report: A 31-year-old male sustained injuries from a road traffic accident on May 16, 2024, and initially received treatment at a nearby government hospital. Two days later, he presented to our facility with chest pain and injuries to his right leg, wrists, and forearm. Physical examination revealed sutured wounds on the right wrist and elbow, along with external fixation on the right leg. Due to the persistence of chest pain, a computed tomography scan was performed, which revealed a displaced sternal body fracture. The cardiothoracic vascular surgery team recommended surgical fixation because of the displacement and ongoing chest pain. On May 20, surgery was conducted by an orthopedic surgeon using a minimally invasive technique with video-assisted thoracoscopic assistance to ensure proper visualization and protection ofvital structures during fixation with two long 3.5 mm pre-bent titanium locking plates using the railroad technique. Care was taken to ensure that the screws did not excessively penetrate the posterior cortex, which was confirmed through thoracoscopy. The post-operative recovery was uneventful, with significantimprovement inchest pain noted atthe 6-week follow-up. Conclusion: This case suggests that minimally invasive fixation with video-assisted thoracoscopy offers faster recovery, shorter hospitalization, and reduced tissue damage, ensuring proper reduction in sternal fractures. The low-profile 3.5 mm titanium locking plate using the railroad techniqueisan effective option for managing transverse sternal fractures. Keywords: Sternal fracture, thoracoscopicallyassisted osteosynthesis, lockingplate. |
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Website: [www.jocr.co.in](www.jocr.co.in)

DOI:
[https://doi.org/10.13107/jocr.2025.v15.i12.6440](https://doi.org/10.13107/jocr.2025.v15.i12.6440) | Author’s Photo Gallery | | | | | | --- | --- | --- | --- | --- | --- | | |
Dr. Deepak D Chitragar | |
Dr. Annamalai Devadoss |
Dr. Meenatchi Sundaram |
Dr. Ratheesh Elangovan | | |
1Department of Orthopaedics, Devadoss Multispeciality Hospital, Madurai, Tamil Nadu, India,
2Department

FAQs

What outcomes and complications were observed after surgery?

Recovery was uneventful with significant chest pain improvement by 6 weeks, and at 6 months there was no pneumothorax or complications such as chest pain persistence, paresthesia, or wound infection.

Sep 30, 2026

Uploaded by dawugda