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Sternum fracture: causes, symptoms, diagnosis, treatment
Last reviewed: 04.07.2025
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ICD-10 code
S22 Fracture of rib(s), sternum and thoracic spine.
[ What causes a sternum fracture?
A sternum fracture occurs mainly with a direct mechanism of injury. The displacement of fragments is usually insignificant, but can also be by the thickness of the bone.
Anatomy of the sternum
The sternum is a long spongy bone. It consists of a manubrium, a body, and a xiphoid process, connected by cartilaginous layers. The manubrium articulates with the clavicles and is fused with the 1st ribs. When connected to the body, an angle is formed that is open to the back - the sternum angle. The latter articulates with the 2nd rib. The cartilages of the 2nd-7th ribs are attached to the body. The sternum performs supporting and protective functions.
Symptoms of a sternum fracture
Victims complain of pain at the fracture site and difficulty breathing due to pain and bleeding in the anterior mediastinum. Blood flows from the broken spongy bone.
Diagnosis of sternum fracture
Anamnesis
The anamnesis includes a corresponding chest injury.
Inspection and physical examination
During examination, swelling and deformation are determined in the sternum area. Palpation reveals sharp pain, deformation due to swelling, and sometimes due to displacement of fragments.
Laboratory and instrumental studies
The diagnosis is confirmed by a lateral chest X-ray. It should be noted that performing and reading chest X-rays presents certain difficulties; a diagnosis of sternum fracture can be reliably made only if the image shows displacement of the fragments.
What do need to examine?
Treatment of sternum fracture
Indications for hospitalization
Treatment of sternum fracture is conservative. It is performed in a hospital setting.
First aid
10 ml of 2% procaine solution and 0.5 ml of 70% alcohol are injected into the fracture site. A large amount of anesthetic should not be injected so as not to increase the volume of the retrosternal hematoma.
Non-drug treatment of sternum fracture
The patient is placed on a shield. If displacement of fragments is detected, they are gradually aligned by hyperextending the thoracic spine. A recliner is placed in the interscapular region, on which the patient should lie for 2-3 weeks. UHF, quartz, mustard plasters, and breathing exercises are indicated.
Drug treatment of sternum fracture
During the treatment of a sternum fracture, painkillers are prescribed.
Surgical treatment of sternum fracture
Surgical treatment of sternum fractures is rarely performed. A vertical incision 6-8 cm long is made above the fracture site. Soft tissues are separated to the right and left. In both fragments, closer to the fracture line, two holes are made so that the end of the awl comes out of the spongy substance at the fracture site. The awl should not be inserted vertically to the sternum to avoid damage to the mediastinal organs. Strong threads or wire are passed through the resulting holes, which are used to fasten the fragments with a U-shaped suture after repositioning.
During osteosynthesis with pins, the edges of the sternum are exposed one or two intercostal spaces above and below the fracture. The fragments are aligned and secured with cross-drawn (obliquely upward) pins. The pin should enter the upper fragment by 3-4 cm, but not exit it along the back surface! The ends of the pins are bitten off and bent.