Cardiac and Vascular Sequelae of Sternal Fractures

Harley, Daniel P.; Mena, Ismaël

doi:10.1097/00005373-198606000-00011

Cited by 64 publications

(30 citation statements)

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“…The standard teaching that sternal fracture (SF) is best diagnosed by lateral chest X-ray (CXR) and that it represents a major, clinically significant injury with high associated morbidity and mortality is based on literature performed in the last millennium before the explosion in use of computed tomography (CT) for blunt trauma patient evaluation [1,2]. When SF is diagnosed, authorities advocate for monitoring with special consideration and workup for cardiac contusion (CC) [3,4].…”

Section: Introductionmentioning

confidence: 99%

Sternal fracture in the age of pan-scan

Perez¹,

Rodriguez²,

Baumann³

et al. 2015

Injury

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Section: Introductionmentioning

confidence: 99%

Sternal fracture in the age of pan-scan

Perez¹,

Rodriguez²,

Baumann³

et al. 2015

Injury

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“…This compares well with other series. 7,15,16,24,27 Passenger position in the vehicle was unknown in 48% of our patients (Table 1), but Brookes et al stated that the incidence of sternal fracture in vehicular trauma victims is constant regardless of the position of the occupant in the vehicle. 26 The majority of sternal fractures in the 27 patients involved the body of the sternum, and the majority were single fractures.…”

Section: Discussionmentioning

confidence: 87%

“…The degree of association of sternal fracture with other types of injury, such as myocardial, major thoracic, vascular and spinal, is, however, significant. [10][11][12][13][14][15][16][17][18] Our objectives are to determine the incidence, morbidity and mortality of patients with fractures of the sternum, to identify specific features of the sternal fracture which may predict the outcome, and to identify the factors that affect the duration of hospital stay in patients with sternal fracture.…”

mentioning

confidence: 99%

Sternal Fracture – Regional Experience

Batouk

1996

Ann Saudi Med

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A retrospective analysis of 27 sternal fracture patients out of 267 patients with chest trauma was done in the period between March 1990March (9-1410 and April 1994April (11-1414 at Asir Central Hospital, giving an incidence of 10% in all chest trauma. There were 25 males and two females, giving a ratio of 12.5:1. The age range was 18-70, with a mean age of 37.5 years and a median age of 35 years. The mean hospital stay was 12.2 days, with a range of 3 to 53 days and a median of seven days. The mechanism of injury and the types of associated injuries are presented. Twentyeight percent of the sternal fracture patients had abnormal electrocardiogram. Echocardiogram was done on only eight patients (32%); two were abnormal. Ann Saudi Med 1996;16(3):285-290. A Batouk, Sternal Fracture -Regional Experience. 1996; 16(3): 285-290 In 1751, Du Verney reported an exceptional case of compound fracture of the sternum in a quarry man.1 In 1864, Gurlt cited a series of 22,616 fractures of all types; among them were only 22 cases of uncomplicated fracture of the sternum caused by indirect violence.2 Different mechanisms have been reported, among which are muscle contraction 3 and labor, 4 but the most frequent cause of sternal fracture is the forceful impact of the sternum against the steering column of an automobile after a rapid deceleration. 5,6 Seat belts have been blamed in many studies. 7-9The bone injury itself has generally been reported as being inconsequential. The degree of association of sternal fracture with other types of injury, such as myocardial, major thoracic, vascular and spinal, is, however, significant. 10-18Our objectives are to determine the incidence, morbidity and mortality of patients with fractures of the sternum, to identify specific features of the sternal fracture which may predict the outcome, and to identify the factors that affect the duration of hospital stay in patients with sternal fracture. MethodsAsir Central Hospital is a 450-bed hospital in Abha City, located in the southwestern region of Saudi Arabia. It is a tertiary hospital, Level II Trauma Center, with a catchment population of one million.Data were collected from the medical records of 267 patients with chest trauma between March 1990 (9-1410) and April 1994April (11-1414, of whom 27 patients had sternal fracture. These were analyzed with regard to demographics, area of sternal fracture, admission electrocardiographic (ECG) and echocardiographic changes, treatment modalities and outcome of treatment.ECG was classified as abnormal when there were arrhythmias, conduction defects, nonspecific ST segment or T-wave changes, evidence of anatomical specific ischemia, sinus tachycardia or any other abnormality interpreted by a cardiologist. Chi-squared, two-tailed, Fisher's exact and Mann-Whitney-Wilcoxon tests were used as tests of significance at a 5% level of significance. ResultsDuring the four-year study period, there were 267 patients who sustained chest trauma, among whom 27 were found to have sternal fracture, giving an ...

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“…Sternal fractures commonly result from motor vehicle collisions, particularly in restrained A B front seat occupants [18]. Some studies have shown that up to 8% to 10% of hospitalised patients with blunt chest trauma had sternal fractures [12,13]. This warrants extra caution when evaluating anterior chest wall trauma.…”

Section: Discussionmentioning

confidence: 99%