Sternal fracture

Background

• Fracture is MORE likely in restrained passengers than unrestrained passengers
• Isolated sternal fx is relatively benign
  • Low mortality (<1%)
  • Low intrathoracic morbidity
• May be associated with:
  • Rib Fracture, Pulmonary Contusion (~10%)
  • Myocardial contusion (1.5-6%)
• No association between sternal fracture and aortic rupture

• sternal fx in 8% of thoracic injuries, seen on pa/lat cxr, many recent studies prove most, if no comorbidities, can be d/c home safely (mort= .8%), chk ekg

Diagnosis

• Anterior chest pain
• Point tenderness over sternum
• Ecchymosis, soft tissue swelling

Work-Up

• Most are visible on LATERAL CXR
  • If fx is seen conservative approach is to obtain chest CT to r/o other pathology
    • May be helpful in determining conservative vs surgical fixation

Treatment

• Pain control

Disposition

• Isolated, non-displaced fx:
  • If can achieve pain control ok to d/c home
• Displaced fx or concern for severe pain or respiratory compromise:
  • Refer for operative fixation

See Also

• Rib Fracture
• Pulmonary Contusion
• Traumatic Pneumothorax

Source

Rosen's