Sternal fracture: Difference between revisions
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==Background== | ==Background== | ||
[[File:Sobo 1909 31.png|thumb|Anatomy of the sternum.]] | [[File:Sobo 1909 31.png|thumb|Anatomy of the sternum.]] | ||
*Fracture is more likely in restrained passengers than unrestrained passengers | *Fracture is more likely in restrained passengers than unrestrained passengers (high-energy trauma) | ||
*Isolated sternal fracture is relatively benign | *Isolated sternal fracture is relatively benign | ||
**Low mortality (<1%) | **Low mortality (<1%) | ||
**Low intrathoracic morbidity | **Low intrathoracic morbidity | ||
*Sternal body fracture most common | |||
===Associated Injuries=== | ===Associated Injuries=== | ||
Revision as of 18:56, 13 June 2020
Background
- Fracture is more likely in restrained passengers than unrestrained passengers (high-energy trauma)
- Isolated sternal fracture is relatively benign
- Low mortality (<1%)
- Low intrathoracic morbidity
- Sternal body fracture most common
Associated Injuries
- Rib fracture
- Pulmonary contusion
- Myocardial contusion (1.5%)
- No association between sternal fracture and aortic rupture
Clinical Features
- Anterior chest pain
- Point tenderness over sternum
- Ecchymosis, soft tissue swelling
Differential Diagnosis
Thoracic Trauma
- Airway/Pulmonary
- Cardiac/Vascular
- Musculoskeletal
- Other
Evaluation
- Imaging
- Most are visible on lateral CXR or on ultrasound
Management
Disposition
- Isolated, non-displaced fracture:
- If pain control achieved and ECG normal ok to discharge home
- Displaced fracture or concern for severe pain or respiratory compromise:
- Refer for operative fixation