Sternal fracture: Difference between revisions
| Line 37: | Line 37: | ||
==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 | ||
Revision as of 19:06, 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