Document Detail


The significance of stable patients with sternal fractures.
MedLine Citation:
PMID:  3824115     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A retrospective review of patients admitted with sternal fractures without massive trauma to the chest or hypotension was undertaken. Chest pain was present in 59 of 60 patients while external signs of bruising were noted in one-third. The standard anteroposterior (AP) roentgenogram of the chest was diagnostic in all patients. Thirty-four (56.7 per cent) patients had 51 significant noncardiac injuries, an average of 1.5 injuries per patient. Most commonly, these were orthopedic injuries, fractures of the rib and closed head injuries. Sixty-two per cent of the patients with sternal fractures had abnormal electrocardiograms (ECG) at some time, of which 34 per cent had ECG changes consistent with ischemia. The admission ECG was normal in 20 (48 per cent) patients. Three of these patients subsequently had significant ECG changes. Fractures that were comminuted or involved the sternal angle were more likely to be associated with ECG abnormalities than were simple fractures of the sternal body. Only three patients had elevated creatine phosphokinase-myocardial bond fractions. Two dimensional echocardiography and biventricular radionuclide angiocardiography were normal in 11 patients, including five patients with ECG abnormalities. There were no deaths related to the sternal fractures per se or to associated injuries. Sternal fractures result from high energy trauma and should be suspected in patients with chest pain after blunt thoracic trauma. The lateral roentgenogram of the chest is the most useful diagnostic test. There is a high incidence of associated cardiac and noncardiac injuries in these patients mandating close observation with ECG monitoring in the intensive care unit.
Authors:
R Buckman; S Z Trooskin; L Flancbaum; J Chandler
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgery, gynecology & obstetrics     Volume:  164     ISSN:  0039-6087     ISO Abbreviation:  Surg Gynecol Obstet     Publication Date:  1987 Mar 
Date Detail:
Created Date:  1987-03-31     Completed Date:  1987-03-31     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0101370     Medline TA:  Surg Gynecol Obstet     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  261-5     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Arrhythmias, Cardiac / diagnosis,  etiology
Child
Contusions / diagnosis,  etiology,  physiopathology
Creatine Kinase / blood
Electrocardiography
Female
Fractures, Bone / complications*,  diagnosis,  radiography
Heart Injuries / diagnosis,  etiology,  physiopathology
Humans
Male
Middle Aged
Retrospective Studies
Sternum / injuries*,  radiography
Time Factors
Chemical
Reg. No./Substance:
EC 2.7.3.2/Creatine Kinase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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