Management of Blunt Sternal Fractures in a Community-Based Hospital
Fathima T Kunhivalappil1, Taleb M Almansoori2, Muhamed Salim AbdulRahman3
1Department of Radiology, Al Rahba Hospital, Abu Dhabi, UAE.
Surgery Research and Practice
|March 23, 2023
Summary
Sternal fractures are identified in blunt trauma patients via computed tomography (CT) scans. Many isolated sternal fractures allow safe emergency department discharge if cardiac enzymes and ECG are normal.
Area of Science:
- Trauma Surgery
- Radiology
- Emergency Medicine
Background:
- Sternal fractures are infrequent in blunt trauma cases.
- Computed tomography (CT) is crucial for diagnosing sternal fractures in chest trauma evaluations.
- This study examines sternal fracture incidence, mechanisms, management, and outcomes in a community hospital setting.
Purpose of the Study:
- To determine the incidence of sternal fractures in patients with blunt trauma.
- To analyze the injury mechanisms, management strategies, and patient outcomes.
- To compare findings with data from tertiary care centers.
Main Methods:
- Retrospective review of chest CT scans from October 2010 to March 2019.
- Inclusion criteria: patients with blunt trauma undergoing chest CT.
- Data collected: demographics, injury details, fracture characteristics, associated injuries, clinical scores, and outcomes.
Main Results:
- 63 sternal fractures identified in 2578 CT scans (2.4% incidence).
- Motor vehicle collisions were the primary injury mechanism.
- The body of the sternum was the most common fracture site (74.6%).
- 31.7% of patients had isolated sternal fractures.
- Mortality rate was 3.2%.
Conclusions:
- The incidence of sternal fractures in this community hospital mirrors that of tertiary centers.
- Patients with sternal fractures, normal cardiac enzymes, and normal ECG can be safely discharged from the emergency department if no other significant injuries are present.
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