Sternal fracture
Revision as of 17:12, 10 November 2015 by Snyderjonathan (talk | contribs)
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:
- 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
Diagnosis
- Imaging
- Most are visible on lateral CXR or on ultrasound
Management
- EKG
- Consider troponin
- Surgeons tend to want trop
- ED providers tend to defer trop if EKG nl
Differential Diagnosis
Thoracic Trauma
- Airway/Pulmonary
- Cardiac/Vascular
- Musculoskeletal
- Other
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