Introduction. Sternal fractures often occur together with serious and life-threatening additional injuries. This retrospective study was designed to assess concomitant injuries and develop a correlation between fracture location and the severity of injury. Methods. All patients ( ) diagnosed with a fracture of the sternum by means of a CT scan were analysed with respect to accident circumstances, fracture morphology and topography, associated injuries, and outcome. Results. Isolated sternal fractures occurred in 9%. In all other admissions, concomitant injuries were diagnosed: mainly rip fractures (64%), injury to the head (48%), the thoracic spine (38%), lumbar spine (27%), and cervical spine (22%). Predominant fracture location was the manubrium sterni. In these locations, the observed mean ISS was the highest. They were strongly associated with thoracic spine and other chest injuries. Furthermore, the incidence of head injuries was significantly higher. ICU admission was significantly higher in patients with manubrium sterni fractures. Conclusion. Sternal fractures are frequently associated with other injuries. It appears that the fracture location can provide important information regarding concomitant injuries. In particular, in fractures of manubrium sterni, the need for further detailed clinical and radiologic workup is necessary to detect the frequently associated injuries and reduce the increased mortality. 1. Introduction The most common mechanisms accounting for sternal fractures are motor vehicle collisions and blunt trauma to the chest and abdomen [1–3]. During the last decades, the detection rate of this injury has increased due to the obligation to wear a seat belt in cars as well as improved imaging through the common use of computed tomography in the emergency room after accidents. Today, a fracture of the sternum is observed in 4% of all traffic accident victims and 3–8% following blunt abdominal trauma [4]. In the past, the general belief was that a sternum fracture represented a serious injury due to commonly associated potentially life-threatening injuries. Some authors have reported mortality rates in patients with sternal fractures ranging from 24% up to as much as 45% [5, 6]. This high mortality rate is due to associated thoracic, pulmonary, cardiac, and spinal injuries [7–11]. Other studies, however, have shown that only one-third of all patients with sternal fractures in fact also suffered from concomitant injuries [12]. The remaining patients sustained isolated sternal fractures which can be classified as harmless injuries.
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