Sternal fracture

Sternal fractures have increased in frequency with the mandatory wearing of seat belts.

A sternal fracture may result from:

• direct trauma - requires quite considerable force and usually associated with other injuries
• violent flexion injury of the thoracic spine - with a thoracic spine wedge fracture

Common causes are road traffic accidents:

• fall on to the steering column of a car
• the seat belt itself

Isolated sternal fractures are not serious and may simply need re-alignment, by reduction and wiring. If displacement is minimal, no treatment is necessary.

The main concern is with damage to the surrounding structures - ribs, myocardium, great vessels, and thoracic spine. A flail segment due to multiple rib fractures may be difficult to manage. A ruptured aorta is life threatening.