Morbidity and mortality associated with fracture of the sternum due to blunt trauma, by fracture type and location

Abstract Objective: To examine the relationship that the types and locations of fractures of the sternum have with mortality and morbidity. Materials and Methods: We analyzed the records of 115 patients diagnosed with fracture of the sternum, due to blunt trauma, between 2007 and 2018. Records of computed tomography studies were obtained from the radiology archive of a tertiary teaching hospital. The type of fracture was classified as linear, displaced, or comminuted, whereas the fracture location was classified as the manubrium, body, or xiphoid process. Results: A total of 108 patients were included in the study. Of those patients, 92 (85.2%) were male and 16 (14.8%) were female. The etiology was a traffic accident in 72 cases (62.6%) and a fall from height in 36 (31.3%). The mean age was 42.1 ± 17.7 years for males and 53.9 ± 20.0 years for females. The mortality rate was 11.1%. Among the 12 deceased patients, the mean age was 44.4 ± 18.3 years. The fracture was located exclusively in the manubrium in 64 patients (59.3%), exclusively in the body of the sternum in 41 (38.0%), and in both locations in three (2.7%), whereas none were located in the xiphoid process. Morbidity rates were higher in the patients with fractures of the manubrium than in those with fractures of the body of the sternum, as was the incidence of accompanying bone fractures and organ injuries. The fracture was linear in 44 patients (40.7%), displaced in 62 (57.4%), and comminuted in 30 (27.8%). The mortality was significantly higher for comminuted fractures than for the other fracture types (p = 0.045; β = 4.40). Conclusion: Fracture of the manubrium can be indicative of the severity of trauma and has a poor prognosis.