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Sternal fractures
- Initially thought to be associated with high mortality due to associated injuries though newer studies show the mortality rate is about 1%.
- Can be associated with
- Rib fractures
- Mediastinal injury
- Cardiac Contusion
- Pneumothorax
- Aortic dissection
- Pulmonary Contusion
- The diagnosis can be made with plain radiographs, but a fracture can be missed on a regular PA and Lateral Chest Xray. Ask for dedicated sternal views to better define the fracture
- CT Chest is only needed if you are concerned about associated injuries
- Obtain an ECG on arrival and at 6 hours to ensure there are no signs of a myocardial contusion
- ST segment changes, arrhthymias
- Treatment is supportive. Provide adequate pain control and treat associated injuries
References
Brookes JG, Dunn RJ, Rogers IR. Sternal fractures: a retrospective analysis of 272 cases. J Trauma. Jul 1993;35(1):46-54. PMID 8331712