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]] | ||
* | ===Workup=== | ||
*CXR or CT | |||
===Diagnosis=== | |||
*Most are visible on lateral CXR | |||
*CT is test of choice if high suspicion | |||
==Management== | ==Management== | ||
Revision as of 19:05, 13 June 2020
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