Sternal fracture: Difference between revisions

Revision as of 03:13, 18 July 2011

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%)
No association between sternal fracture and aortic rupture

S/S
- Anterior chest pain
- Point tenderness over sternum
- Ecchymosis, soft tissue swelling
Imaging
- Most are visible on lateral CXR or on ultrasound

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

Tintinalli

Authors:

@@ Line 6: / Line 6: @@
 *May be associated with:
 **[[Rib Fracture]], [[Pulmonary Contusion]] (~10%)
-**Myocardial contusion (1.5-6%)
+**Myocardial contusion (1.5%)
 *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
+*S/S
-*Point tenderness over sternum
+**Anterior chest pain
-*Ecchymosis, soft tissue swelling
+**Point tenderness over sternum
+**Ecchymosis, soft tissue swelling
-==Work-Up==
+*Imaging
-*Most are visible on LATERAL CXR
+**Most are visible on lateral CXR or on ultrasound
-**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
+**If can achieve pain control and ECG nl ok to d/c home
 *Displaced fx or concern for severe pain or respiratory compromise:
 **Refer for operative fixation
@@ Line 38: / Line 30: @@
 ==Source==
-Rosen's
+Tintinalli
 [[Category:Trauma]]