Sternal fractures: a red flag or a red herring?

We reviewed the records of 28 patients with sternal fractures. Seat belts were used by 79% of the patients. Pain and tenderness were the most common complaints. Forty-six percent of patients had associated injuries, which were all evident in the emergency room. Seven patients had rib fractures, six had myocardial contusion, and five had pulmonary contusions. The associated injuries determined the outcome: 2 patients died, 2 required rehabilitation, the rest recovered uneventfully. Mean length of stay (LOS) was 8.17 +/- 1.78 days, but the median LOS was 4 days, and 75% stayed a week or less. The sternal fracture was treated with rest and analgesics. We conclude that sternal fractures are benign and do not require special treatment or an expensive work-up. It is possible that the seat belt and the sternal fracture absorb a substantial part of the energy transfer, and prevent greater damage.