Abstract
PurposeTraumatic 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.MethodsA 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.ResultsSixteen 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.ConclusionsTreatment 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.
Highlights
Sternal fractures are rare injuries with an incidence of less than 0.5% of all fractures and an estimated 3–8% in blunt trauma patients [1–4]
The aim of this study was to conduct a systematic literature review to provide an overview of the current treatment practice and outcomes of traumatic sternal fractures
Articles were excluded if they involved the treatment of non-traumatic sternal fractures or dislocations, or fractures caused by cardiopulmonary resuscitation, or if they were review articles
Summary
Sternal fractures are rare injuries with an incidence of less than 0.5% of all fractures and an estimated 3–8% in blunt trauma patients [1–4]. Traumatic sternal dislocations occur even less frequently [5]. The most common mechanism of injury is direct blunt trauma to the anterior chest caused by motor vehicle accidents [1, 6–8]. The incidence of sternal injury has increased since the introduction of seatbelt legislation [3, 9, 10]. Sternal injuries are frequently caused by falls from height or indirect trauma due to spinal flexioncompression injury [1, 2, 5, 6, 11].
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