{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T03:07:04Z","timestamp":1776827224572,"version":"3.51.2"},"reference-count":23,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"1","license":[{"start":{"date-parts":[[2009,1,1]],"date-time":"2009-01-01T00:00:00Z","timestamp":1230768000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery. British volume"],"published-print":{"date-parts":[[2009,1]]},"abstract":"<jats:p> We have reviewed our experience in managing 11 patients who sustained an indirect sternal fracture in combination with an upper thoracic spinal injury between 2003 and 2006. These fractures have previously been described as \u2018associated\u2019 fractures, but since the upper thorax is an anatomical entity composed of the upper thoracic spine, ribs and sternum joined together, we feel that the term \u2018fractures of the upper transthoracic cage\u2019 is a better description. These injuries are a challenge because they are unusual and easily overlooked. They require a systematic clinical and radiological examination to identify both lesions. This high-energy trauma gives severe devastating concomitant injuries and CT with contrast and reconstruction is essential after resuscitation to confirm the presence of all the lesions. The injury level occurs principally at T4\u2013T5 and at the manubriosternal joint. These unstable fractures need early posterior stabilisation and fusion or, if treated conservatively, a very close follow-up. <\/jats:p>","DOI":"10.1302\/0301-620x.91b1.20769","type":"journal-article","created":{"date-parts":[[2008,12,17]],"date-time":"2008-12-17T18:07:46Z","timestamp":1229537266000},"page":"91-96","source":"Crossref","is-referenced-by-count":17,"title":["Fractures of the upper transthoracic cage"],"prefix":"10.1302","volume":"91-B","author":[{"given":"J.-L.","family":"Labbe","sequence":"first","affiliation":[{"name":"Service de Chirurgie, Orthop\u00e9dique CHT, Noum\u00e9a BP J5, New Caledonia, Melanesia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O.","family":"Peres","sequence":"additional","affiliation":[{"name":"Service de Chirurgie, Orthop\u00e9dique CHT, Noum\u00e9a BP J5, New Caledonia, Melanesia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O.","family":"Leclair","sequence":"additional","affiliation":[{"name":"Service de Chirurgie, Orthop\u00e9dique CHT, Noum\u00e9a BP J5, New Caledonia, Melanesia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Goulon","sequence":"additional","affiliation":[{"name":"Service de Chirurgie, Orthop\u00e9dique CHT, Noum\u00e9a BP J5, New Caledonia, Melanesia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Scemama","sequence":"additional","affiliation":[{"name":"Service de Chirurgie, Orthop\u00e9dique CHT, Noum\u00e9a BP J5, New Caledonia, Melanesia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Jourdel","sequence":"additional","affiliation":[{"name":"Service de Chirurgie, Orthop\u00e9dique CHT, Noum\u00e9a BP J5, New Caledonia, Melanesia."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"42","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-198903000-00014"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.68B2.3957997"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-005-0001-y"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199310000-00033"},{"key":"R5","unstructured":"Shields TW, LoCicero J, Ponn RB. 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