Sternum fracture

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  • Fracture is more likely in restrained passengers than unrestrained passengers
  • Isolated sternal fracture 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


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


  • ECG
  • Consider troponin
    • Surgeons tend to want trop
    • ED providers tend to defer trop if ECG nl

Differential Diagnosis

Thoracic Trauma


  • 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

See Also