[Traumatic XXXX in adult: about two surgical cases].

@entity1 @entity662 @entity174 @entity397 @entity158 @entity2720 @entity10
Traumatic @entity2720 are rare in adult and occur readily during a violent traumatism of the chest and/or the dorsal spine. We report two cases treated between September 1997 and August 2002 at the Surgical Emergency Department of Le Dantec Hospital. The first observation was related to a 26 year old lady. On September 27, 1997, she fell down from a tree and received all the weight of the body on her two arms. She was referred because of anterior @entity662 , increasing with respiration associated with injuries of the 2 wrists. On conventional X-ray, a @entity2720 (anterior dislocation of the sternal body with respect to the manubrium) was diagnosed. The mechanism of the dislocation was indirect: flexion-compression of the sternum caused by a hyperflexion of the dorsal spine when the @entity1 touched the ground. There was also a Pouteaux-Colles @entity174 of the 2 wrists. The dislocation was surgically treated: open reduction followed by manubriosternal stabilization using wires. The 2 wrists were treated by Kapandji procedure. At the 21st postoperative day, a @entity397 of the wires required a 2nd internal fixation of the sternum by wires. After 9 years, the @entity1 is without complaint and the chest X-ray is normal. The second observation was that of a 19 year old young @entity1 , referred on August 15, 2002 after a frontal crash with a car while crossing the road. She fell down on her back. She was complaining from severe @entity10 with a normal Glasgow Scale (15), anterior chest and right hand @entity158 . Radiological examinations showed a @entity174 of the occipital bone without embarrure and a type I @entity2720 (posterior displacement of the sternal body in relation to the manubrium) which mechanism was direct: direct shock against the sternum. There were also an isolated @entity174 of 4 right sided ribs and a @entity174 without displacement of the 3 last bones of the right metacarpus. An orthopaedic treatment was carried out for the lesions of the right hand and an abstention-monitoring suggested for the @entity174 . The @entity2720 was surgically reduced and stabilized by using a braided polyester thread number 2. After 4 years, the @entity1 is asymptomatic and the manobriosternal joint is stable. We emphasize on the scarcity and the mechanism of traumatic @entity2720 in adult, the frequency of associated injuries and the absence of consensus about their treatment.
