Diagnosis and Management of Sternal Fracture at a Single Center 2019-2024: A Retrospective Study of 127 Emergency...

BACKGROUND Sternal fractures (SF) are uncommon but clinically significant injuries that can indicate severe blunt chest trauma and are frequently associated with multi-system injuries. This study aimed to evaluate the differences between displaced and non-displaced SF in terms of demographics, mechanisms, associated injuries, imaging, cardiac findings, and biomarkers. MATERIAL AND METHODS This retrospective cross-sectional study included patients with radiologically confirmed SF who presented to the Emergency Department (ED) of a tertiary center between March 2019 and December 2024. Patient data, including demographics, trauma mechanisms, Glasgow Coma Scale (GCS) scores, imaging findings, associated injuries, electrocardiographic and echocardiographic findings, laboratory parameters, hospitalization details, and outcomes were extracted from electronic hospital records. Patients were categorized into displaced and non-displaced SF groups based on CT reports. RESULTS Of 127 patients (median age 43 years; 70.1% male), 46.5% had displaced fractures. Motor vehicle accidents were the leading mechanism (62.2%). Displaced fractures were significantly associated with head trauma (50.8% vs 26.5%, p=0.005), abdominal trauma (33.9% vs 8.8%, p<0.001), upper-extremity injuries (40.7% vs 23.5%, p=0.030), and ST-segment changes on ECG (35.6% vs 11.8%, p<0.001). Biomarkers, including CK-MB, CK, AST, glucose, and WBC, were significantly higher in patients with displaced fractures. Overall mortality was 4.7%, with higher mortality in patients with displaced fractures (8.5% vs 1.5%, p=0.075). CONCLUSIONS Displaced SFs are markers of high-energy trauma and are associated with multi-system injuries, abnormal ECG findings, and elevated biomarkers. Recognition of these factors should prompt comprehensive imaging and cardiac monitoring in the ED. Although mortality was more frequent in displaced fractures, the difference was not statistically significant.