Traumatic and Atraumatic Sternal Fractures: Analysis of 13 Cases

Abstract

Objective: Sternal fracture (SF) occurs as a result of trauma or a pathological process. In this study, patients with SF were evaluated in terms of traumatic and atraumatic etiology, diagnosis and treatment. Material and Methods: Between 2006-2010; fracture etiology, location, shape, associated pathology, treatment modalities, complications and length of hospital stay were reviewed retrospectively in 13 patients with SF. In all cases, the lateral chest X-ray and electrocardiogram (ECG) had been performed. Cardiac enzymes had been measured in patients with traumatic etiology. Results: Of SF subjects, 11 had a traumatic etiology and 2 had an atraumatic etiology (osteoporosis). Sternal fracture was located in the corpus of the sternum in 9 patients, and in the manubrium in 4 cases, while it was displaced in 5 patients, and non-displaced in 8 cases. The ECG changes in five patients, elevated cardiac enzymes in 7 patients and pathology in echocardiography in 3 cases were detected. The most common injuries were associated with rib fractures (54.5%) and extremity fractures (27.3%), respectively. There was a vertebral osteoporotic fracture in two patients with atraumatic SF. One case underwent surgical fixation, while three patients underwent tube thoracostomy. Conclusion: Whether or not accompanying trauma, SF should be considered and sternum X-ray should be requested in patients presenting with chest pain, and especially when an atraumatic fracture is detected, osteoporosis should be kept in mind among the etiological causes. ECG monitoring of patients for cardiac injury, cardiac enzyme monitoring and echocardiography should be done if necessary.