RESUMO
The authors report a novel application of cement augmentation for treatment of a symptomatic sternal fracture. Sternal fractures often cause debilitating pain and can affect ventilation. Given the success of vertebroplasty in patients in treating back pain, the authors used a similar technique in a 56-year-old woman with chronic obstructive pulmonary disease and an acute comminuted sternal fracture refractory to conservative management. The authors used computed tomography guidance and cement augmentation for the fracture. The patient subsequently reported good pain relief and improved breathing. Sternoplasty may be a viable alternative for patients with sternal fractures and refractory pain.
Assuntos
Cimentos Ósseos , Fraturas Cominutivas/terapia , Procedimentos Ortopédicos , Dor/prevenção & controle , Polimetil Metacrilato/administração & dosagem , Radiografia Intervencionista/métodos , Esterno/lesões , Tomografia Computadorizada por Raios X , Feminino , Fraturas Cominutivas/complicações , Fraturas Cominutivas/diagnóstico por imagem , Humanos , Injeções , Pulmão/fisiopatologia , Pessoa de Meia-Idade , Dor/diagnóstico por imagem , Dor/etiologia , Medição da Dor , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Esterno/diagnóstico por imagem , Resultado do TratamentoRESUMO
In recent years, three-dimensional (3D) multiplanar reformatted images from conventional cross-sectional computed tomographic (CT) data have been increasingly used to better demonstrate the anatomy and pathologic conditions of various organ systems. Three-dimensional volume-rendered (VR) CT images can aid in understanding the temporal bone, a region of complex anatomy containing multiple small structures within a relatively compact area, which makes evaluation of this region difficult. These images can be rotated in space and dissected in any plane, allowing assessment of the morphologic features of individual structures, including the small ossicles of the middle ear and the intricate components of the inner ear. The use of submillimeter two-dimensional reconstruction from CT data in addition to 3D reformation allows depiction of microanatomic structures such as the osseous spiral lamina and hamulus. Furthermore, 3D VR CT images can be used to evaluate various conditions of the temporal bone, including congenital malformations, vascular anomalies, inflammatory or neoplastic conditions, and trauma. The additional information provided by 3D reformatted images allows a better understanding of temporal bone anatomy and improves the ability to evaluate related disease, thereby helping to optimize surgical planning.