Initially thought to be associated with high mortality due to associated injuries though newer studies show the mortality rate is about 1%.
Can be associated with
Rib fractures
Mediastinal injury
Cardiac Contusion
Pneumothorax
Aortic dissection
Pulmonary Contusion
The diagnosis can be made with plain radiographs, but a fracture can be missed on a regular PA and Lateral Chest Xray. Ask for dedicated sternal views to better define the fracture
CT Chest is only needed if you are concerned about associated injuries
Obtain an ECG on arrival and at 6 hours to ensure there are no signs of a myocardial contusion
ST segment changes, arrhthymias
Treatment is supportive. Provide adequate pain control and treat associated injuries
References
Brookes JG, Dunn RJ, Rogers IR. Sternal fractures: a retrospective analysis of 272 cases. J Trauma. Jul 1993;35(1):46-54. PMID 8331712
