+1 Recommend
1 collections
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Morbidity and mortality associated with fracture of the sternum due to blunt trauma, by fracture type and location Translated title: Morbidade e mortalidade associadas a fraturas de esterno decorrentes de traumas contusos, por tipos de fratura e localização


      Read this article at

          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.



          To examine the relationship that the types and locations of fractures of the sternum have with mortality and morbidity.

          Materials and Methods

          We analyzed the records of 115 patients diagnosed with fracture of the sternum, due to blunt trauma, between 2007 and 2018. Records of computed tomography studies were obtained from the radiology archive of a tertiary teaching hospital. The type of fracture was classified as linear, displaced, or comminuted, whereas the fracture location was classified as the manubrium, body, or xiphoid process.


          A total of 108 patients were included in the study. Of those patients, 92 (85.2%) were male and 16 (14.8%) were female. The etiology was a traffic accident in 72 cases (62.6%) and a fall from height in 36 (31.3%). The mean age was 42.1 ± 17.7 years for males and 53.9 ± 20.0 years for females. The mortality rate was 11.1%. Among the 12 deceased patients, the mean age was 44.4 ± 18.3 years. The fracture was located exclusively in the manubrium in 64 patients (59.3%), exclusively in the body of the sternum in 41 (38.0%), and in both locations in three (2.7%), whereas none were located in the xiphoid process. Morbidity rates were higher in the patients with fractures of the manubrium than in those with fractures of the body of the sternum, as was the incidence of accompanying bone fractures and organ injuries. The fracture was linear in 44 patients (40.7%), displaced in 62 (57.4%), and comminuted in 30 (27.8%). The mortality was significantly higher for comminuted fractures than for the other fracture types ( p = 0.045; β = 4.40).


          Fracture of the manubrium can be indicative of the severity of trauma and has a poor prognosis.

          Translated abstract


          Examinar a relação entre o tipo e a localização da fratura de esterno com mortalidade e morbidade.

          Materiais e Métodos

          Foram analisados os prontuários de 115 pacientes com diagnóstico de fratura de esterno por trauma contuso entre 2007 e 2018. Os registros de estudos de tomografia computadorizada foram obtidos do arquivo de radiologia de um hospital universitário terciário. O tipo de fratura foi classificado como linear, deslocado ou cominutivo, enquanto o local da fratura foi classificado como no manúbrio, no corpo ou no processo xifoide.


          Cento e oito pacientes foram incluídos no estudo. Desses, 92 (85,2%) eram do sexo masculino e 16 (14,8%) eram do sexo feminino. As causas foram acidente de trânsito em 72 casos (62,6%) e queda de altura em 36 (31,3%). A média de idade foi de 42,1 ± 17,7 anos para os homens e de 53,9 ± 20,0 anos para as mulheres. A taxa de mortalidade foi de 11,1%. Entre os 12 pacientes que faleceram, a média de idade foi de 44,4 ± 18,3 anos. A fratura localizou-se apenas no manúbrio em 64 pacientes (59,3%), somente no corpo do esterno em 41 (38,0%) e em ambas as localizações em três pacientes (2,7%), e nenhuma ocorreu no apêndice xifoide. As taxas de morbidade foram maiores nos pacientes com fraturas no manúbrio do que nos com fraturas no corpo do esterno, assim como a incidência de fraturas ósseas e lesões de órgãos adjacentes. A fratura foi linear em 44 pacientes (40,7%), deslocada em 62 (57,4%) e cominutiva em 30 (27,8%). A mortalidade foi significativamente maior nos casos de fraturas cominutivas do que em outros tipos de fratura ( p = 0,045; β = 4,40).


          A fratura do manúbrio pode ser um indicativo da gravidade do trauma e de mau prognóstico.

          Related collections

          Most cited references21

          • Record: found
          • Abstract: found
          • Article: not found

          Sternal fractures: a retrospective analysis of 272 cases.

          To determine the incidence, morbidity, and mortality associated with fractures of the sternum. A retrospective review of the medical records of all patients treated in an emergency department with the radiologic diagnosis of sternal fracture during a 6 1/2 year period between January 1, 1985 and June 30, 1991. A level II trauma center in the eastern suburbs of Melbourne, Australia. 272 patients were eligible for analysis. Only 6 patients of 251 involved in motor vehicle collisions were documented as not wearing seatbelts. The incidence of sternal fracture as a result of motor vehicle collisions was 3%. Sternal fracture is more common in female victims and the elderly and is associated with a very low incidence of cardiac arrhythmias requiring treatment. It has a mortality of 0.7%. Sternal fracture is a common injury in a population where restraints are frequently used. PATIENTS with an isolated sternal fracture do not require cardiac monitoring and those under 40 years of age may be cared for in a short stay ward.
            • Record: found
            • Abstract: found
            • Article: found
            Is Open Access

            Current treatment and outcomes of traumatic sternal fractures—a systematic review

            Purpose Traumatic sternal fractures are rare injuries. The most common mechanism of injury is direct blunt trauma to the anterior chest wall. Most (> 95%) sternal fractures are treated conservatively. Surgical fixation is indicated in case of fracture instability, displacement or non-union. However, limited research has been performed on treatment outcomes. This study aimed to provide an overview of the current treatment practices and outcomes of traumatic sternal fractures and dislocations. Methods A systematic review of literature published from 1990 to June 2017 was conducted. Original studies on traumatic sternal fractures, reporting sternal healing or sternal stability were included. Studies on non-traumatic sternal fractures or not reporting sternal healing outcomes, as well as case reports (n = 1), were excluded. Results Sixteen studies were included in this review, which reported treatment outcomes for 191 patients. Most included studies were case series of poor quality. All patients showed sternal healing and 98% reported pain relief. Treatment complications occurred in 2% of patients. Conclusions Treatment of traumatic sternal fractures and dislocations is an underexposed topic. Although all patients in this review displayed sternal healing, results should be interpreted with caution since most included studies were of poor quality.
              • Record: found
              • Abstract: found
              • Article: found
              Is Open Access

              Sternal fractures and their management

              Sternal fractures are predominantly associated with deceleration injuries and blunt anterior chest trauma. Sternal trauma must be carefully evaluated by monitoring of vital parameters and it is of paramount importance that concomitant injuries are excluded. Nevertheless, routine admission of patients with isolated sternal fractures for observation is still common in today's practice, which is often unnecessary. This article aims to describe the prognosis, the recommended assessment and management of patients with sternal fractures, to help clinicians make an evidence-based judgment regarding the need for hospitalization.

                Author and article information

                Radiol Bras
                Radiol Bras
                Radiologia Brasileira
                Publicação do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem
                May-Jun 2022
                May-Jun 2022
                : 55
                : 3
                : 167-172
                [1 ]Dicle University, Medical School, Diyarbakır, Turkey.
                Author notes
                Correspondence: Sadullah Şimşek, MD. Dicle University, Medical School, Department of Radiology. Sur 21280 Diyarbakır, Turkey. sadullahsimsek@ 123456gmail.com.
                Author information

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                : 02 May 2021
                : 17 August 2021
                Original Article

                sternum/injuries,fractures,bone/mortality,wounds and injuries,esterno/lesões,fraturas ósseas/mortalidade,ferimentos e lesões


                Comment on this article