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Related Experiment Videos

Sternal fractures in blunt chest trauma: a practical algorithm for management

W C Chiu1, L F D'Amelio, J S Hammond

  • 1Department of Surgery, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick 08903-0019, USA.

The American Journal of Emergency Medicine
|May 1, 1997
PubMed
Summary

Sternal fractures in blunt trauma patients are not associated with significant myocardial injury. Cardiac evaluation and monitoring are not routinely necessary for these patients, allowing focus on other injuries.

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Area of Science:

  • Traumatology
  • Cardiology
  • Emergency Medicine

Background:

  • Sternal fractures can occur in blunt trauma, raising concerns about potential underlying cardiac injury.
  • The clinical significance of myocardial injury in patients with isolated sternal fractures requires further investigation.

Purpose of the Study:

  • To determine the relationship between sternal fractures and clinically significant myocardial injury.
  • To assess the utility of cardiac evaluation and monitoring in blunt trauma patients with sternal fractures.

Main Methods:

  • Retrospective review of medical records of blunt trauma patients with sternal fracture.
  • Inclusion criteria: level 1 trauma center admission, June 1990 to June 1993.
  • Exclusion criteria: severe associated injuries (Abbreviated Injury Score >3), Glasgow Coma Scale score <15.

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Main Results:

  • Thirty-three patients with sternal fracture were identified; most resulted from motor vehicle crashes.
  • No electrocardiogram (ECG) or echocardiogram findings indicated acute cardiac injury or ischemia.
  • No significant arrhythmias or elevated creatine kinase-MB (CPK-MB) fraction (>5%) were observed.

Conclusions:

  • Sternal fracture alone is not a reliable marker for clinically significant myocardial injury.
  • Cardiac evaluation and monitoring may not be routinely indicated for isolated sternal fractures.
  • Management should prioritize treatment of associated injuries in patients with sternal fractures.