[Fractures of the sternum]

Assessment of the authors' group of patients with a fracture of sternum and comparison with available literary findings.

In a group of 188 patients with a blunt injury of chest who were hospitalised in the Faculty Hospital in Olomouc in the period of 1996-1999 there were 7 cases with the diagnosis of the fracture of sternum. In this group of patients we observed the cause of injury, occurrence of associated injuries, the potential of diagnostic methods, method of treatment and duration of hospitalization.

Mostly they were patients with an isolated fracture of the sternum or with an associated injury requiring only a short-term hospitalization. One patient with a rupture of v. azygos died from the sequelae of other multiple injuries. Another patient sustained a fracture of sternum together with a massive hemothorax and hemomediastinum. On the basis of circulation stability this patient was treated conservatively. For details see the case report. Six patients were subsequently transferred to out-patient department and are now without complaints.

The most beneficial examination for the diagnosis of the fracture of sternum remains lateral radiograph of the chest. With regard to potential injuries of mediastinal organs it is necessary to perform ap radiograph of the chest and ECG, in indicated cases also CT of the chest, angiography and echocardiography, if need be. In patients treated for a fracture of sternum the duration of hospitalization and mortality is determined by the severity of the associated injuries. Surgical treatment is considered rarely in fractures with a greater dislocation or in injuries or mediastinal organs.

The incidence of the fracture of sternum has recently increased. Isolated injuries of the chest do not pose any diagnostic or therapeutic problem. Of much greater severity are associated injuries of lungs and mediastinal organs which require a precise diagnosis and careful observation of the patient.