Salih KÜR, Kadir Baturhan ÇİFLİK, Ekin ZORLU, Nesimi GÜNAL
Eurasian Journal of Emergency Medicine - 2026;25(1):210-221
Aim: Sternal fractures are relatively uncommon. Although most sternal fractures are managed conservatively, the presence of associated injuries to adjacent organs is associated with a significant increase in morbidity and mortality. This study aimed to evaluate the clinical characteristics, associated thoracic and extrathoracic injuries, management strategies, and outcomes of patients with traumatic sternal fractures. Materials and Methods: Patients diagnosed with sternal fractures following thoracic trauma between January 2013 and May 2021 were retrospectively analyzed. Demographic data, mechanism of injury, fracture localization and type, concomitant injuries, seatbelt use, Injury Severity score (ISS), length of hospital stay, and mortality were assessed. Results: Sternal fractures were identified in 230 of 2131 patients with thoracic trauma (10.7%). Traffic accidents were the most common mechanism of injury (n=189, 82.2%). Most fractures involved the sternal body (n=129, 56.1%) and were non-displaced (n=128, 55.7%). Retrosternal hematoma was detected in 10% of patients and was significantly associated with hemothorax and pulmonary contusion (p=0.021, p=0.033). Patients not using seatbelts had significantly higher ISS values and longer hospital stays (p=0.005, p=0.001). Thirteen patients (5.7%) died, predominantly due to severe associated injuries. Conclusion: Although most sternal fractures can be managed conservatively, the presence of a retrosternal hematoma may indicate underlying pulmonary injury rather than cardiac involvement. Careful radiological evaluation and close in-hospital monitoring are essential to optimize outcomes and reduce mortality in these patients.
