Sternal fracture

Dr Vikas Shah and Dr Henry Knipe et al.

Sternal fractures occur in ~5% of blunt chest trauma with the manubrium being the most commonly injured part.

Acute, severe sternal pain that is worse with respiration with localized tenderness.

Fractures of the sternum can result from both direct and indirect blunt force trauma to the chest with motor vehicle accidents the most common cause 1,3:

  • direct: impact on a steering wheel; falls; contact sports; pedestrian vs. car accidents; assaults
  • indirect: deceleration injuries from motor vehicle accidents; stress fractures; osteoporotic fractures
  • non-accidental injuries in children

Associated injuries are common, occurring in ~50% (range 33-67%) of patients 1,3:

Sternal fractures are best detected on dedicated lateral sternal views as lucent cortical breaches with or without displacement. Undisplaced fractures are poorly visualized on plain x-rays.

  • can also be used to assess for sternal fractures
  • as with plain X-ray, US can show a cortical fracture or step
  • just as accurate as lateral radiographs but less reliable in determining displacement 5
  • modality of choice; sagittal reformats most sensitive
  • can assess for anterior cortical breach and posterior cortical breach, with the latter being associated with more severe neurovascular injuries 3

Isolated sternal injuries have a very good outcome with conservative management with most healing in a few months with a very low mortality rate (<1%) 1. However, sternal fractures associated with other injuries have a higher mortality rate.

Fractures
Share article

Article information

rID: 27745
Synonyms or Alternate Spellings:
  • Sternum fractures
  • Sternal fractures
  • Sternum fracture
  • Fracture of the sternum

Support Radiopaedia and see fewer ads

Cases and figures

  • Case 1: with T3 fracture
    Drag here to reorder.
  • Case 2: on ultrasound
    Drag here to reorder.
  • Case 3
    Drag here to reorder.
  • Case 4: on ultrasound
    Drag here to reorder.
  • Case 5: displaced
    Drag here to reorder.
  • Case 6: with thoracic spine fracture
    Drag here to reorder.
  • Case 8: non-united body fracture
    Drag here to reorder.
  • Case 9
    Drag here to reorder.
  • Case 10
    Drag here to reorder.
  • Case 11
    Drag here to reorder.
  • Case 12
    Drag here to reorder.
  • Updating… Please wait.

     Unable to process the form. Check for errors and try again.

     Thank you for updating your details.