Vol 14, No 1-2 (2012)
Original articles
Published online: 2012-11-19
Isolated sternal fractures
Paweł Nitkowski, Robert M. Proczka, Jerzy A. Polański
Chirurgia Polska 2012;14(1-2):48-51.
Vol 14, No 1-2 (2012)
Original articles
Published online: 2012-11-19
Abstract
Our in-patient surgical department during the time period from January 2003 to December 2009 saw 28
patients who were hospitalised with an isolated fracture of the sternum. The purpose of observing these
patients in the surgical ward was to exclude any possible complications of blunt cardiac trauma or injury
to the large mediastinal vessels. According to numerous previous reports in the literature, sternal fractures
may be related to the occurrence of such sequelae.
All patients admitted to the surgical unit had routine chest x-ray pictures taken in the AP (anterior-posterior)
and lateral views, specifically targeting the sternum, as well as a routine electrocardiogram (ECG).
Some patients also had an echocardiograph (ECHO) performed and cardiac enzyme levels assessed.
None of the patients at the time of admission, nor during their hospital stay, had any clinical, radiological,
or electrocardiographic signs suggestive of a cardiac contusion or a traumatic injury to the thoracic aorta
or other great vessels of the mediastinum. None of the hospitalised patients had any complications
which required surgical intervention.
The widespread use of safety belts in cars and the rapid growth of motorisation is associated with an
increase in the number of isolated fractures of the sternum. Therefore, it is of increasing importance to
develop appropriate standards of treatment in this type of trauma situation. Our experience, as well as a review of recently published reports has prompted us to introduce the
following recommendations in our centre: patients with isolated sternal fractures, with no other abnormalities
seen on the chest X-ray and with a normal electrocardiogram do not require routine observation
in the surgical ward. Echocardiography or the evaluation of cardiac enzyme levels is not necessary with
the routine diagnosis of uncomplicated fractures of the sternum.
Abstract
Our in-patient surgical department during the time period from January 2003 to December 2009 saw 28
patients who were hospitalised with an isolated fracture of the sternum. The purpose of observing these
patients in the surgical ward was to exclude any possible complications of blunt cardiac trauma or injury
to the large mediastinal vessels. According to numerous previous reports in the literature, sternal fractures
may be related to the occurrence of such sequelae.
All patients admitted to the surgical unit had routine chest x-ray pictures taken in the AP (anterior-posterior)
and lateral views, specifically targeting the sternum, as well as a routine electrocardiogram (ECG).
Some patients also had an echocardiograph (ECHO) performed and cardiac enzyme levels assessed.
None of the patients at the time of admission, nor during their hospital stay, had any clinical, radiological,
or electrocardiographic signs suggestive of a cardiac contusion or a traumatic injury to the thoracic aorta
or other great vessels of the mediastinum. None of the hospitalised patients had any complications
which required surgical intervention.
The widespread use of safety belts in cars and the rapid growth of motorisation is associated with an
increase in the number of isolated fractures of the sternum. Therefore, it is of increasing importance to
develop appropriate standards of treatment in this type of trauma situation. Our experience, as well as a review of recently published reports has prompted us to introduce the
following recommendations in our centre: patients with isolated sternal fractures, with no other abnormalities
seen on the chest X-ray and with a normal electrocardiogram do not require routine observation
in the surgical ward. Echocardiography or the evaluation of cardiac enzyme levels is not necessary with
the routine diagnosis of uncomplicated fractures of the sternum.
Keywords
sternum fracture; complication; thorax injury
Keywords
sternum fracture
complication
thorax injury
Authors
Paweł Nitkowski
Robert M. Proczka
Jerzy A. Polański