Sternum fractures and effects of associated injuries

Aim of this study was to determine the clinical characteristics, morbidity and mortality in patients with a sternum fracture (SF).

From October 1998 to December 2008, 80 patients with sternal fractures were admitted to the Thoracic Surgery Department of the University Hospital. The records of all patients were reviewed retrospectively. Patients' age and gender, extent of sternal and thoracic injury, types of associated injuries, treatment and outcome, the length of hospital stay, morbidity and mortality were collected. We divided our patients into two groups: Group I with an isolated sternum fracture and Group II with a sternum fracture and additional injury.

Patients' ages ranged from 18 to 83 years with an average age of 48.7 +/- 15.4 years. There were 67 male (84 %) and 13 female (16 %) patients. Thirty-five patients (44 %) sustained an isolated SF and the remaining 45 (56 %) had a SF in combination with associated injuries. The commonest etiology of the SF was a motor vehicle accident (77 %). Most of the fractures were located at the sternal body (76 %). The most common associated injuries were rib fractures (30 %), followed by extremity injuries (18 %). The great majority of patients (81 %) was treated with conservative measures such as bed rest, analgesia, etc. The remainder was treated either by tube thoracostomy (15 %), thoracotomy (1.25 %) or sternal fixation (2.5 %). There was no mortality and morbidity in Group I, but the morbidity and mortality rates of Group II were 15 % and 1 %, respectively. Mean length of hospital stay for all the patients was 5.7 days.

Isolated SFs are benign entities that can be safely managed with rest and analgesia. Associated injuries in patients with SF determine the morbidity and length of hospital stay.