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Management of isolated sternal fractures using a practical algorithm.

Dimos Karangelis1, Konstantinos Bouliaris2, Theocharis Koufakis2

  • 1Department of Cardiac Surgery, Manchester Royal Infirmary, Manchester, United Kingdom ; Department of Cardiovascular and Thoracic Surgery, University Hospital of Larissa, Greece.

Journal of Emergencies, Trauma, and Shock
|August 13, 2014
PubMed
Summary

Isolated sternal fractures (ISFs) are increasing due to seat belt laws. Most ISFs from car crashes require no further cardiac investigation if initial tests are normal, simplifying patient management.

Keywords:
Cardiac contusioncardiac traumasternal fractures

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Area of Science:

  • Trauma surgery
  • Emergency medicine
  • Orthopedic surgery

Background:

  • Seat belt legislation has increased isolated sternal fractures (ISFs) in motor vehicle crashes.
  • ISFs are a growing concern in trauma care.

Purpose of the Study:

  • To determine the frequency of ISFs.
  • To review management strategies for ISFs.
  • To define the average hospitalization length for ISFs.

Main Methods:

  • Retrospective review of 64 sternal fracture patients from January 2008 to April 2012.
  • Focused analysis on 45 patients with isolated sternal fractures.
  • Examined injury mechanisms, hospitalization duration, morbidity, and mortality.

Main Results:

  • All 45 ISF patients were involved in motor vehicle crashes, with 91% wearing seat belts.
  • Average hospital length of stay was 1.85 days.
  • No cardiac complications or deaths occurred; two patients had prolonged hospitalization due to abnormal ECG and cardiac enzymes.

Conclusions:

  • Isolated sternal fractures with normal initial cardiac evaluations (ECG, enzymes, chest X-ray) and no complications do not require further investigation.
  • This approach can streamline patient care and resource utilization.