Sternal fracture - Revision history

Rossdonaldson1: /* Evaluation */

2021-04-10T13:12:35Z

Evaluation

← Older revision		Revision as of 13:12, 10 April 2021
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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 ~~associated~~ with retrosternal haematoma (black arrow). Also aortic injury (white arrows).]]		[[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

2021-04-10T13:11:50Z

Evaluation

← Older revision		Revision as of 13:11, 10 April 2021
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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 associated 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

2020-06-13T19:06:00Z

Disposition

← Older revision		Revision as of 19:06, 13 June 2020
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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

2020-06-13T19:05:31Z

Evaluation

← Older revision		Revision as of 19:05, 13 June 2020
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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]]
	*~~Imaging~~		===Workup===
	**Most are visible on lateral CXR ~~or on ultrasound~~		*CXR or CT

			===Diagnosis===
			*Most are visible on lateral CXR
			*CT is test of choice if high suspicion

	==Management==		==Management==

2020-06-13T18:56:50Z

Background

← Older revision		Revision as of 18:56, 13 June 2020
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	==Background==		==Background==
	[[File:Sobo 1909 31.png\|thumb\|Anatomy of the sternum.]]		[[File:Sobo 1909 31.png\|thumb\|Anatomy of the sternum.]]
	*Fracture is more likely in restrained passengers than unrestrained passengers		*Fracture is more likely in restrained passengers than unrestrained passengers (high-energy trauma)
	*Isolated sternal fracture is relatively benign		*Isolated sternal fracture is relatively benign
	**Low mortality (<1%)		**Low mortality (<1%)
	**Low intrathoracic morbidity		**Low intrathoracic morbidity
			*Sternal body fracture most common

	===Associated Injuries===		===Associated Injuries===

2020-06-13T18:55:33Z

Background

← Older revision		Revision as of 18:55, 13 June 2020
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	**Low mortality (<1%)		**Low mortality (<1%)
	**Low intrathoracic morbidity		**Low intrathoracic morbidity
	*May be associated with:
	**[[Rib ~~Fracture~~]], [[Pulmonary ~~Contusion~~]]		===Associated Injuries===
	**Myocardial contusion (1.5%)		*[[Rib fracture]]
	*No association between sternal fracture and aortic rupture		*[[Pulmonary contusion]]
			*[[Myocardial contusion]] (1.5%)
			*<u>No</u> association between sternal fracture and aortic rupture

	==Clinical Features==		==Clinical Features==

2020-06-13T18:54:10Z

Background

← Older revision		Revision as of 18:54, 13 June 2020
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	==Background==		==Background==
			[[File:Sobo 1909 31.png\|thumb\|Anatomy of the sternum.]]
	*Fracture is more likely in restrained passengers than unrestrained passengers		*Fracture is more likely in restrained passengers than unrestrained passengers
	*Isolated sternal fracture is relatively benign		*Isolated sternal fracture is relatively benign

2020-06-13T18:50:14Z

Management

← Older revision		Revision as of 18:50, 13 June 2020
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	*[[ECG]]		*[[ECG]]
	*Consider [[troponin]]		*Consider [[troponin]]
	**Surgeons tend to want troponin
	**ED providers tend to defer troponin if ECG normal

	==Disposition==		==Disposition==

2020-06-13T18:49:59Z

← Older revision		Revision as of 18:49, 13 June 2020
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	*Point tenderness over sternum		*Point tenderness over sternum
	*Ecchymosis, soft tissue swelling		*Ecchymosis, soft tissue swelling

			==Differential Diagnosis==
			{{Thoracic trauma DDX}}

	==Evaluation==		==Evaluation==
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	==Management==		==Management==
	*[[ECG]]		*[[ECG]]
	*Consider troponin		*Consider [[troponin]]
	**Surgeons tend to want ~~trop~~		**Surgeons tend to want troponin
	**ED providers tend to defer ~~trop~~ if ECG nl		**ED providers tend to defer troponin if ECG normal


	~~==Differential Diagnosis==~~
	~~{{Thoracic trauma DDX}}~~

	==Disposition==		==Disposition==

2020-06-13T18:49:00Z

Evaluation

← Older revision		Revision as of 18:49, 13 June 2020
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	==Evaluation==		==Evaluation==
	[[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]]
	*Imaging		*Imaging
	**Most are visible on lateral CXR or on ultrasound		**Most are visible on lateral CXR or on ultrasound