Isolated fractures of the sternum and their management

Sternal fractures are traumatic chest injuries, which relate primarily to road accidents. They were once considered to be high morbidity injuries, which has now been reversed, especially for isolated sternal fractures. This is a retrospective study that focuses on the clinical presentation of patients with isolated sternal fracture and their management. During the period of time 01/2009–01/2016, sixty two patients were examined in the emergency department with isolated sternal fracture. All patients had chest X-ray and sternum X-ray, blood tests and ECG and, according to the results and the symptoms, patients were admitted or discharged after observation in the short stay ward unit. Other parameters that have been studied were the cause of sternal fracture, age and sex. The average age of patients was 51.3 years, with age ranging from 17 to 79 years. There were 27 men and 35 women. The main cause of sternal fracture was traffic accidents (72.6%), followed by falls from height (21%) and assault (6.4%). Out of 62 patients, only four had to be admitted because of pathological ECG findings and increased CK-MB, while 58 were kept under observation for six hours and then discharged with oral analgesia, instructions and follow-up in the outpatient clinic. Isolated sternal fractures are considered benign injuries with a good prognosis, which require no special treatment except sufficient pain control, particularly in cases where there is no sign of displacement. Admission is required in patients with altered blood tests and abnormal ECG for monitoring for at least 48 hours.