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Sternum Fracture

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What is sternum?

The sternum, colloquially known a s breast bone is the bone that is present in the center of the chest and supports and attaches to the ribs. This bone is sword shaped. Sternum itself has 3 other bones that combine to complete its structure; these are:

–         Manubrium sternum

–         Body of sternum

–         Xiphoid process or Xiphi sternum

Sternum is a flat bone of the body. Flat bones provide support and a wide surface area for the attachment of muscles. One important function of flat bones is to produce RBCs and other elements of blood from red marrow (bone marrow). Sternum is therefore also involved in producing blood and its formed elements.

Sternum fracture (breakage) is seen in females more commonly than males and in adults above 50. Sternum fracture occurs most of the time due to direct blow over the bone.

Sternum is a strong bone and only a hard blow or impact to the bone can break it. This means that the blow will not only break the bone, it will be associated with other injuries too which might involve, vertebrae and ribs etc. soft tissues and organs present in the vicinity may also be affected and blood vessels may also rupture.

What are the causes of fracture?

The breast bone is broken usually because of:

–         Automobile accidents ( without airbags and seatbelts)

–         Contact sports e.g. football

–         Diseases that cause bone weakening (pathologic fracture)

The above causes indicate that the impact over the bone is the most important thing causing fracture. Pathologic fractures in this case are rare.

When does a sternum fracture become a medical emergency?

A sternum fracture becomes a medical emergency if the fractured part of the bone rips or damages vital organs like heart and lungs and causes contusions.

What signs and symptoms accompany a bone fracture?

–         Crepitus “ a crunching sound that comes when the broken ends of bone rub against each other)

–         Intense pain (which may increase with coughing, sneezing etc.)

–         Tenderness and bruising

–         Swelling

–         Deformed appearance of ribcage.

 

Most fractures occur on the body of sternum. Sternum fracture is confirmed by an X-ray.

Treatment :

People who have pathologic fractures of sternum are treated for the underlying cause (or disease).

The severity of fracture is checked first of all so that the treatment may begin accordingly. If any organ is involved or other injuries are present, they are taken care of firstly. Surgery may also be performed in these cases.

If only bone is fractured, rest is advised. The fracture heals in 10-24 weeks.
Icing is also helpful and causes the pain to alleviate pain. Ice may be wrapped in a towel to pat it over the injured area. No direct application is to be done.

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Pressure application is also to be avoided. No weightlifting or any other work that conveys stress to the bone.

Painkillers may be taken to relieve pain for chest pain is normally witnessed during healing period.

Non union or mal union of the bone is rarely seen in sternum fractures.

 

See also:

https://www.doctortipster.com/18976-new-technology-reducing-need-for-pain-meds.html

References

https://www.physioadvisor.com.au/14651050/sternal-fracture-fractured-sternum-physioadvis.htm

https://www.mdguidelines.com/fracture-sternum-closed