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Myth of the dangerous sternal fracture
1Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
Study Objective:
To look at the hospital course and the outcome of patients with an isolated sternal fracture.
Design:
Retrospective analysis of hospital records.
Setting:
A large urban Level I trauma center.
Type Of Participant:
Blunt trauma patients with an isolated sternal fracture. Patients with other chest radiograph abnormalities were excluded, as were those with abnormal admission ECGs.
Measurements And Main Results:
Thirty-one patients with an isolated sternal fracture were identified. No patient developed new ECG changes or arrhythmias during the hospital stay. Cardiac enzymes were elevated in one patient (3.2%). No patient had any adverse cardiopulmonary outcome attributable to the sternal fracture.
Conclusion:
The outcome of patients with an isolated sternal fracture and a normal ECG is very good. Routine admission and cardiac monitoring do not appear to be warranted in this subset of patients with a sternal fracture.