bubble_chart Overview

Fracture of the sternum is often caused by direct force or compression of the anterior chest, typically occurring at the body or the junction of the manubrium and body.

bubble_chart Etiology

A sternal fracture is often caused by direct force or compression to the front of the chest, typically occurring at the body of the sternum or the junction between the manubrium and the body.

bubble_chart Clinical Manifestations

Pain and swelling in the sternal region, aggravated by coughing and deep inspiration. If combined with rib fracture, paradoxical breathing may occur.

bubble_chart Diagnosis

1. History of trauma with direct or indirect violence impact on the anterior chest wall.

2. Symptoms such as chest pain, chest tightness, and dyspnea. Physical examination reveals local swelling, tenderness, and palpable bone crepitus, with abnormal movement or deformity (protrusion/depression) during respiration.

3. Pay attention to whether there is concurrent spinal cord injury at the same level.

4. Lateral or oblique chest X-ray may reveal sternal fracture and displacement. {|103|}

bubble_chart Treatment Measures

1. For fractures without displacement and no complications in the chest wall or thoracic cavity, 10-20ml of 1% procaine can be injected at the fracture site for analgesia, followed by chest bandaging for 2-3 weeks.

2. For displaced fractures, the following methods can be used for treatment:

(1) Hyperextension reduction method. The patient lies supine on a hard board bed with the back appropriately elevated to hyperextend the head, neck, and chest, allowing the fracture to reduce. Maintain the hyperextended position for half a month. For overlapping deformities, another reduction method can be adopted: under local or epidural anesthesia, the patient hyperextends the head, raises both upper limbs overhead, and slowly rotates the arms while applying counter-traction to the body. Once the fracture is reduced, fix it with a gypsum bandage for 2-4 weeks.

(2) Surgical reduction method. Under general anesthesia with endotracheal intubation, a longitudinal incision is made at the fracture site, and the fracture ends are separated using a periosteal elevator. The patient is hyperextended dorsally to reduce the sternal fracture fragments. Two or three holes are drilled in the upper and lower bone fragments, and the fracture is fixed with stainless steel wire sutures. The incision is closed without drainage.

(3) For sternal fractures with paradoxical respiration, external traction or internal fixation can be used for correction.