Diagnostic Considerations

Sternal fractures are rare. They tend to behave clinically such as avulsion fracture injuries to the capsuloligamentous structure of the inferior sternoclavicular joint. For high-demand athletes, early identification, surgical reduction, and fixation are likely to achieve the best outcomes.^[20]

Sternal fracture may be associated with major and serious injuries. Patients with isolated sternal fracture with displacement greater than 0.5 cm and hematoma are likely to require cardiac consultation.^[21]

No significant association has been observed between the depth of sternal fracture displacement and blunt cardiac injury. Further evaluation and management for blunt cardiac injury should be reserved in the absence of additional symptoms or findings.^[22]

Differential Diagnoses

Workup

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Media Gallery

Posterior surface of the sternum.
Lateral radiograph shows a complete displaced fracture of the sternum (arrow).

of 2

Author

Scott Felten, MD, FACEP Residency Director for Emergency Medicine Physicians, Attending Physician, Emergency Medicine Physicians, St Francis Medical Center

Scott Felten, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians

Disclosure: Nothing to disclose.

Coauthor(s)

Mark S Slabinski, MD, FACEP, FAAEM Vice President, USACS Central

Mark S Slabinski, MD, FACEP, FAAEM is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, Ohio State Medical Association

Disclosure: Nothing to disclose.

Mark B Sigler, MD Resident Physician, Department of Emergency Medicine, University of Oklahoma College of Medicine, Tulsa

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

David B Levy, DO, FAAEM Senior Consultant in Emergency Medicine, Waikato District Health Board, New Zealand; Associate Professor of Emergency Medicine, Northeastern Ohio Universities College of Medicine

David B Levy, DO, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, Fellowship of the Australasian College for Emergency Medicine, American Medical Informatics Association, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Trevor John Mills, MD, MPH Chief of Emergency Medicine, Veterans Affairs Northern California Health Care System; Professor of Emergency Medicine, Department of Emergency Medicine, University of California, Davis, School of Medicine

Trevor John Mills, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians

Disclosure: Nothing to disclose.

Acknowledgements

Michelle Ervin, MD Chair, Department of Emergency Medicine, Howard University Hospital

Michelle Ervin, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, National Medical Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.