Sternal fractures in blunt trauma patients

Fokin, Alexander A.; Knight, Joanna Wycech; Abid, Ayesha T; Yoshinaga, Kai; Alayon, Amaris; Grady, Robert E.; Weisz, Russell; Puente, Ivan

doi:10.1007/s00068-021-01871-1

Cited by 8 publications

(8 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Isolated sternal fractures only compromise one fifth of all sternal fractures reported. 15 Therefore, one institution would likely not have enough isolated sternal fracture patients for an adequate study, leading us to use ISS and age to case match our patients to attempt to control for other associated injuries. Even though the average ISS scores were the same in both groups, our study population had multiple injuries that could influence the results of this study.…”

Section: Discussionmentioning

confidence: 99%

“…Another limitation is related to the presence of concomitant injuries in our patient population. Isolated sternal fractures only compromise one fifth of all sternal fractures reported 15 . Therefore, one institution would likely not have enough isolated sternal fracture patients for an adequate study, leading us to use ISS and age to case match our patients to attempt to control for other associated injuries.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of Sternal Fixation on Patient Outcomes: A Case Matched Review

Bauman

Todd²,

Raposo-Hadley³

et al. 2022

J Trauma Acute Care Surg

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impact of Sternal Fixation on Patient Outcomes: A Case Matched Review

Bauman

Todd²,

Raposo-Hadley³

et al. 2022

J Trauma Acute Care Surg

View full text Add to dashboard Cite

show abstract

“…Sternal fractures were strongly associated with blunt cardiac injury. Previous studies reported sternal fractures in approximately 2% of blunt trauma cases [ 33 , 34 ], while in 2.4–8% of patients with sternal fractures, blunt cardiac injury were also observed [ 33 , 35 , 36 , 37 ]. Observational studies in the United States and Germany using large databases have also reported that sternal fracture is associated with blunt cardiac injury [ 1 , 2 ].…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Cardiac/Pericardial Injury among Blunt Injury Patients: A Nationwide Study in Japan

Ishida

Katayama

Kitamura

et al. 2022

JCM

View full text Add to dashboard Cite

The lack of established diagnostic criteria makes diagnosing blunt cardiac injury difficult. We investigated the factors associated with blunt cardiac injury using the Japan Trauma Data Bank (JTDB) in a multicenter observational study of blunt trauma patients conducted between 2004 and 2018. The primary outcome was the incidence of blunt cardiac/pericardial injury. Multivariable logistic regression analysis was used to identify factors independently associated with blunt cardiac injuries. Of the 228,513 patients, 1002 (0.4%) had blunt cardiac injury. Hypotension on hospital arrival (adjusted odds ratio (AOR) 4.536, 95% confidence interval (CI) 3.802–5.412), thoracic aortic injury (AOR 2.722, 95% CI 1.947–3.806), pulmonary contusion (AOR 2.532, 95% CI 2.204–2.909), rib fracture (AOR 1.362, 95% CI 1.147–1.618), sternal fracture (AOR 3.319, 95% CI 2.696–4.085). and hemothorax/pneumothorax (AOR 1.689, 95% CI 1.423–2.006)) was positively associated with blunt cardiac injury. Regarding the types of patients, car drivers had a higher rate of blunt cardiac injury compared to other types of patients. Driving a car, hypotension on hospital arrival, thoracic aortic injury, pulmonary contusion, rib fracture, sternal fracture, and hemothorax/pneumothorax were positively associated with blunt cardiac injury.

show abstract

“…Of all trauma admissions in the emergency department (ED), only 0.33–2.1% involve a sternal fracture (SF) due to blunt chest trauma [ 1 , 2 ]. Motor vehicle accidents account for 83–84% of all SFs, while only 10–13% of SFs are due to falls, usually from height [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…Direct chest trauma is not the only possible mechanism of injury (MOI); a fall on the back could cause an SF due to flexion-compression [ 5 ]. Additional skeletal or visceral injuries are present in approximately 80% of patients with an SF due to blunt chest trauma [ 1 , 2 ]. An isolated SF is diagnosed in the absence of concomitant injuries, and it can be described as a relatively mild injury [ 3 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Isolated sternal fracture after low-energy trauma in a geriatric patient: a case report

Sairanen

Arponen

2022

Int J Emerg Med

View full text Add to dashboard Cite

Background Falls are a common cause of emergency department (ED) visits for the older population. If osteoporosis is present, even falls from standing height can lead to unusual fractures normally associated with high-energy trauma. In this report, we analyze a rare case of an isolated sternal fracture with an unusual mechanism of injury. Our discussion aims to improve care for older adults with fall-related fractures. Case presentation An 86-year-old female presented in the ED of our hospital with a complaint of chest pain. She recalled a fall at home the previous day and described how her fist was impacted between the floor and her chest. A physical examination revealed local tenderness in the mid-chest. A lateral chest x-ray indicated a sternal fracture, and a chest computed tomography scan ruled out concomitant injuries. There were no acute changes on her electrocardiogram (ECG). Conservative outpatient treatment was started, and referrals were made with a recommendation to initiate fall prevention measures and osteoporosis screening in primary health care. Conclusions Geriatric patients can present in the ED with a rare sternal fracture even after only a minor chest trauma. Appropriate imaging and an ECG are warranted to exclude life-threatening additional injuries. An in-depth physical examination and an understanding of the exact mechanism of injury are important to avoid missing fractures in unexpected locations. Modern ED physicians could have an important role in the secondary prevention of fall-related fractures for geriatric patients.

show abstract

Sternal fractures in blunt trauma patients

Cited by 8 publications

References 32 publications

Impact of Sternal Fixation on Patient Outcomes: A Case Matched Review

Impact of Sternal Fixation on Patient Outcomes: A Case Matched Review

Factors Associated with Cardiac/Pericardial Injury among Blunt Injury Patients: A Nationwide Study in Japan

Isolated sternal fracture after low-energy trauma in a geriatric patient: a case report

Contact Info

Product

Resources

About