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Sternal fractures as a manifestation of abusive injury in children
Sloane Hechter1, Dirk Huyer, David Manson
1Department of Diagnostic Imaging, Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G 1X8, Canada.
Background:
Sternal fractures are rare injuries in children. The rarity of this injury is likely due to both the relative plasticity of the pediatric thorax and to the difficulty in establishing a radiographic diagnosis without dedicated views. Current literature suggests that this injury in young children is highly specific for abusive injury.
Hypothesis:
Sternal fractures are not highly specific for abusive injury.
Materials And Methods:
This was a retrospective radiographic and clinical chart review of all documented sternal fractures over an 11-year period at a large pediatric hospital.
Results:
Of 12 children with sternal fractures identified, four were < or = 2 years of age and eight were > or = 3 years of age. The mechanism of injury was suspicious for child abuse in two children. Both of these children were < or = 2 years of age. In one toddler, an unwitnessed injury resulted in extensive initial familial anxiety until abusive injury was excluded.
Conclusion:
Sternal fractures are unusual injuries, yet they, in themselves, are not highly specific for abusive injury.
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