Sternal fracture: Difference between revisions

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==Background==
==Background==
*Fracture is MORE likely in restrained passengers than unrestrained passengers
*Fracture is more likely in restrained passengers than unrestrained passengers
*Isolated sternal fx is relatively benign
*Isolated sternal fx is relatively benign
**Low mortality (<1%)
**Low mortality (<1%)
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==Disposition==
==Disposition==
*Isolated, non-displaced fx:
*Isolated, non-displaced fx:
**If can achieve pain control and ECG nl ok to d/c home
**If pain control achieved and ECG normal ok to d/c home
*Displaced fx or concern for severe pain or respiratory compromise:
*Displaced fx or concern for severe pain or respiratory compromise:
**Refer for operative fixation
**Refer for operative fixation

Revision as of 16:16, 12 April 2012

Background

  • 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:
  • No association between sternal fracture and aortic rupture

Clinical Features

  • Anterior chest pain
  • Point tenderness over sternum
  • Ecchymosis, soft tissue swelling

Diagnosis

  • Imaging
    • Most are visible on lateral CXR or on ultrasound

Disposition

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

See Also

Source

Tintinalli