Title: Sternal Fractures<br/>Author: Michael Bond<br/><a href='http://umem.org/profiles/faculty/78/'>[Click to email author]</a><hr/><p>
        <u><strong>Sternal fractures</strong></u></p>
<ul>
        <li>
                Initially thought to be associated with high mortality due to associated injuries though newer studies show the mortality rate is about 1%.</li>
        <li>
                Can be associated with
                <ul>
                        <li>
                                Rib fractures</li>
                        <li>
                                Mediastinal injury</li>
                        <li>
                                Cardiac Contusion</li>
                        <li>
                                Pneumothorax</li>
                        <li>
                                Aortic dissection</li>
                        <li>
                                Pulmonary Contusion</li>
                </ul>
        </li>
        <li>
                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
                <ul>
                        <li>
                                CT Chest is only needed if you are concerned about associated injuries</li>
                </ul>
        </li>
        <li>
                Obtain an ECG on arrival and at 6 hours to ensure there are no signs of a myocardial contusion
                <ul>
                        <li>
                                ST segment changes, arrhthymias</li>
                </ul>
        </li>
        <li>
                Treatment is supportive. Provide adequate pain control and treat associated injuries</li>
</ul>
<fieldset><legend>References</legend>

                <p>
        Brookes JG, Dunn RJ, Rogers IR. Sternal fractures: a retrospective analysis of 272 cases. <em>J Trauma</em>. Jul 1993;35(1):46-54. PMID 8331712</p>
</fieldset>