Sternal fracture: Difference between revisions
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[[File:DisplacedSternalFracture.jpg|thumb|A displaced sternal fracture as seen on lateral X-ray.]] | [[File:DisplacedSternalFracture.jpg|thumb|A displaced sternal fracture as seen on lateral X-ray.]] | ||
[[File:Sternal fracture CT.jpg|thumb|Comminuted sternal fracture on CT]] | [[File:Sternal fracture CT.jpg|thumb|Comminuted sternal fracture on CT]] | ||
[[File:PMC3259405 13244 2011 72 Fig25 HTML.png|thumb|Axial CT showing sternal fracture with retrosternal haematoma (black arrow). Also aortic injury (white arrows).]] | |||
===Workup=== | ===Workup=== | ||
*CXR or CT | *[[CXR]] or CT | ||
===Diagnosis=== | ===Diagnosis=== | ||
*Most are visible on lateral CXR | *Most are visible on lateral [[CXR]] | ||
*CT is test of choice if high suspicion | *CT is test of choice if high suspicion | ||
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==Disposition== | ==Disposition== | ||
*Isolated, non-displaced fracture: | *Isolated, non-displaced fracture: | ||
**If pain control achieved and ECG normal ok to discharge home | **If pain control achieved and [[ECG]] normal ok to discharge home | ||
*Displaced fracture or concern for severe pain or respiratory compromise: | *Displaced fracture or concern for severe pain or respiratory compromise: | ||
**Refer for operative fixation | **Refer for operative fixation | ||
Latest revision as of 13:12, 10 April 2021
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
Workup
- CXR or CT
Diagnosis
- Most are visible on lateral CXR
- CT is test of choice if high suspicion
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