Open Chest Wound with Sternal Fracture in the Emergency Department, a Case Report
Alexandra Ortego1, Vivek Sharma1
1NYU Grossman Long Island School of Medicine, Department of Emergency Medicine, Mineola, NY.
Journal of Education & Teaching in Emergency Medicine
|February 9, 2026
Summary
This case study details a rare open chest wound with a pathologic sternal fracture caused by chronic infection, malignancy, and sternal osteomyelitis. Early evaluation and multidisciplinary care are crucial for managing complex chest wounds and preventing severe complications.
Area of Science:
- Medical Case Study
- Surgical Oncology
- Infectious Disease
Background:
- A 69-year-old male presented with a large, open anterior chest wound and chronic ulceration.
- History of remote chest trauma from a firecracker 30 years prior, leading to an untreated chronic wound.
Purpose of the Study:
- To highlight a rare and complex case of an open chest wound with a pathologic sternal fracture.
- To emphasize the importance of early medical evaluation and a multidisciplinary approach in managing such conditions.
Main Methods:
- Surgical resection of the affected area.
- Chest wall reconstruction utilizing a rectus myocutaneous flap.
- Histopathological analysis of tissue samples.
Main Results:
- Confirmation of squamous cell carcinoma and sternal osteomyelitis.
- Successful chest wall reconstruction.
- The patient presented with an open sternal fracture and exposed pericardium.
Conclusions:
- Managing large chronic chest wounds and pathologic sternal fractures secondary to malignancy and osteomyelitis is complex.
- Early medical evaluation and a multidisciplinary approach are essential for improving patient outcomes.
- Clinicians need heightened awareness to prevent complications like osteomyelitis and pathological fractures.
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