Myth of the dangerous sternal fracture

Abstract

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.