J Korean Soc Radiol.  2015 May;72(5):305-312. 10.3348/jksr.2015.72.5.305.

Traumatic Sternal Fracture: Incidence, Causes, and CT Features

• Kim HW
• Kim YT
• Jou SS
• Han JK
• Bae WK

• KMID: 1793885
• DOI: http://doi.org/10.3348/jksr.2015.72.5.305

Abstract

PURPOSE
To evaluate the incidence of sternal fracture due to trauma, the CT features of sternal fractures, and the hospitalization period.
MATERIALS AND METHODS
The medical records and CT images of 755 patients who suffered trauma from January 2012 to August 2013 were analyzed retrospectively. We compared the incidence of sternal fracture due to various traumatic causes. We evaluated the location and shape of the sternal fracture on CT scans and the relationship between a sternal fracture and the hospitalization period.
RESULTS
The incidence of sternal fracture was 9.27% (70/755) in all patients; 11.7% (53/453) due to a traffic accident (TA), and 5.63% (17/302) due to other causes. TA was the most frequent cause (75.71%) of a sternal fracture, fracture incidences after a TA differed by traumatic cause (p < 0.05). Among sternal fractures, the body was the most commonly involved (68.57%), one wall was limited (32.85%), and anteroposterior length increased (7.14%). Body fractures involving two or more segments included 33.33% of the cases. The hospitalization period was not related with sternal fracture (p = 0.30).
CONCLUSION
fracture was more frequent after a TA than due to other causes. Fracture incidences after a TA depended on the traumatic causes. Involvement of two or more segments and one wall-limitation were common among sternal fractures. Sternal fractures occurred even in slightly injured patients.

MeSH Terms

Accidents, Traffic
Hospitalization
Humans
Incidence*
Medical Records
Retrospective Studies
Sternum
Tomography, X-Ray Computed

Figure

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  Fig. 1 Fracture of sternal body in a 35-year-old man who was struck by heavy object. Sagittal image shows a comminuted fracture involving the mid and lower portion of the sternal body. There is a peristernal hematoma (arrowhead) at the retrosternal area.

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  Fig. 2 Multiple sternal fractures in a 38-year-old woman with driver accident. Sagittal CT scan and curved coronal images show multiple fractures (arrows) in the manubrium and body of the sternum.

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  Fig. 3 Multiple fractures in sternal manubrium and body in a 69-year-old man with driver accident. On sagittal image, the anteroposterior length is increased with fractures (arrowheads) at the upper one-third of the sternal body. There are also focal cortical defects at the lower portion of the manubrium (curved arrow) and at the anterior wall of the lower body (open arrow). Volume rending and curved coronal images show two or more segmental fractures at the upper and lower portion of the sternal body (open arrowheads). Volume rendering and curved coronal images are useful for diagnosing sternal fracture, when a cortical defect of the sternum is only seen without displacement on axial and sagittal images.

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  Fig. 4 Fracture of sternal manubrium in a 43-year-old woman with driver accident. A. Sagittal CT scan shows a focal defect (arrow) at the anterior cortex of the manubrium and a focal radiolucency in the adjacent medulla. Volume rendering image of the sternum shows one wall-limited fracture (open arrowhead) of the manubrium. B. Bone scintigraphy obtained 10 days after CT scan shows a hot uptake (open arrowhead) in the inferior portion of the manubrium.

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