Pediatric sternal fractures from a Level 1 trauma center
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In brief
In brief
Retrospective review of 19 pediatric sternal fractures over 16 years at a Level 1 trauma center found these injuries are rare (0.07% of admissions), typically result from high-velocity mechanisms like motor vehicle accidents, and frequently present with significant associated injuries including pulmonary contusions, rib fractures, and substernal hematomas requiring thorough evaluation.
Written by the GCMD Library team from the article.
Background/purpose
Sternal fractures are rare in children. The purpose of this series is to document traumatic findings in pediatric patients with sternal fractures at a Level 1 trauma center.
Study design
We reviewed the charts of patients with radiologically confirmed sternal fractures from a trauma database at a pediatric Level 1 trauma center between January 1, 2000 and December 31, 2015. We report mechanisms of injury, associated injuries, complications, and outcomes associated with sternal fractures.
Results
Over the 16-year period, 19/25,781 (0.07%) admitted patients had radiologically confirmed sternal fractures. 15/19 (78.9%) patients were male. The median age was 14 years, with interquartile range 10–16 years. 7/19, (36.8%) were sustained owing to motor vehicle accidents. Associated injuries included substernal hematoma (n = 6), pulmonary contusion (n = 4), vertebral injury (n = 2), rib fracture (n = 4), intraabdominal injury (n = 3), pneumothorax (n = 3), long bone injury (n = 3) traumatic brain injury (n = 2), hemothorax (n = 2), pneumomediastinum (n = 2) and cardiac contusion (n = 1).
Conclusions
In this series, pediatric sternal fractures were caused by high velocity mechanisms and had significant comorbidity. While patients with isolated sternal fractures may be candidates for emergency department discharge, a thorough evaluation should be performed in children with sternal fractures to identify concurrent injuries.
Level of evidence
Level IV.