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Management of isolated sternal fractures using a practical algorithm.

Karangelis D, Bouliaris K, Koufakis T, Spiliopoulos K, Desimonas N, Tsilimingas N - J Emerg Trauma Shock (2014)

Bottom Line: Two patients had abnormal ECG and abnormal cardiac enzymes which contributed in prolonged hospitalization.However, there was no incidence of cardiac complications or deaths.ISFs, with normal electrocardiogram, cardiac enzymes, and chest X-ray in the absence of complications, require no further investigation.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiac Surgery, Manchester Royal Infirmary, Manchester, United Kingdom ; Department of Cardiovascular and Thoracic Surgery, University Hospital of Larissa, Greece.

ABSTRACT

Background: The implementation of seat belt legislation has led to an increase in the frequency of isolated sternal fractures (ISFs) in motor vehicle crash.

Aims: We reviewed retrospectively the medical records of our tertiary center in order to find out the frequency of ISFs, review our experience in their management, and define the mean length of hospitalization.

Materials and methods: From January 2008 to April 2012, 64 patients were admitted to the accident and emergency department of the University Hospital of Larissa, Greece, suffering from sternal fractures (SFs). Of these 64 patients, 45 had sustained ISF, while the remaining 19 had SF and additional injuries (intrathoracic and extrathoracic). The files of these 45 patients were further investigating as concerning the mechanism of injury, hospitalization days, morbidity, and mortality.

Results: All the patients had been involved in motor vehicle crashes and most of them were wearing seat belts during the accident (91%). The hospital length of stay (LOS) was 1.85 ± 1.67. All the patients had upon admission chest radiograms, serial electrocardiographs (ECGs), echocardiograms, and cardiac enzyme levels. Two patients had abnormal ECG and abnormal cardiac enzymes which contributed in prolonged hospitalization. However, there was no incidence of cardiac complications or deaths.

Conclusions: ISFs, with normal electrocardiogram, cardiac enzymes, and chest X-ray in the absence of complications, require no further investigation.

No MeSH data available.


Related in: MedlinePlus

A patient with an isolated fracture of the sternum, who has no concomitant injuries, no significant past medical history; with the ECG, chest X-ray and echo being normal and without a cardiac enzyme elevation can be discharged home on regular analgesics after a short period of observation. Algorithm for management of sternal fractures
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Figure 1: A patient with an isolated fracture of the sternum, who has no concomitant injuries, no significant past medical history; with the ECG, chest X-ray and echo being normal and without a cardiac enzyme elevation can be discharged home on regular analgesics after a short period of observation. Algorithm for management of sternal fractures

Mentions: The authors would also like to propose a potential algorithm that could be of significant assistance for the better assessment and management of ISFs [Figure 1]. Our primary goal is to reduce the number of ISF admissions and the length of hospitalization, but not overlooked patients with possible severe accompanying injuries. According to our algorithm, a patient who has sustained a SF with no concomitant injuries, can be safely discharged on oral analgesics after 6-12 h of observation if he meets the following criteria:


Management of isolated sternal fractures using a practical algorithm.

Karangelis D, Bouliaris K, Koufakis T, Spiliopoulos K, Desimonas N, Tsilimingas N - J Emerg Trauma Shock (2014)

A patient with an isolated fracture of the sternum, who has no concomitant injuries, no significant past medical history; with the ECG, chest X-ray and echo being normal and without a cardiac enzyme elevation can be discharged home on regular analgesics after a short period of observation. Algorithm for management of sternal fractures
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4126116&req=5

Figure 1: A patient with an isolated fracture of the sternum, who has no concomitant injuries, no significant past medical history; with the ECG, chest X-ray and echo being normal and without a cardiac enzyme elevation can be discharged home on regular analgesics after a short period of observation. Algorithm for management of sternal fractures
Mentions: The authors would also like to propose a potential algorithm that could be of significant assistance for the better assessment and management of ISFs [Figure 1]. Our primary goal is to reduce the number of ISF admissions and the length of hospitalization, but not overlooked patients with possible severe accompanying injuries. According to our algorithm, a patient who has sustained a SF with no concomitant injuries, can be safely discharged on oral analgesics after 6-12 h of observation if he meets the following criteria:

Bottom Line: Two patients had abnormal ECG and abnormal cardiac enzymes which contributed in prolonged hospitalization.However, there was no incidence of cardiac complications or deaths.ISFs, with normal electrocardiogram, cardiac enzymes, and chest X-ray in the absence of complications, require no further investigation.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiac Surgery, Manchester Royal Infirmary, Manchester, United Kingdom ; Department of Cardiovascular and Thoracic Surgery, University Hospital of Larissa, Greece.

ABSTRACT

Background: The implementation of seat belt legislation has led to an increase in the frequency of isolated sternal fractures (ISFs) in motor vehicle crash.

Aims: We reviewed retrospectively the medical records of our tertiary center in order to find out the frequency of ISFs, review our experience in their management, and define the mean length of hospitalization.

Materials and methods: From January 2008 to April 2012, 64 patients were admitted to the accident and emergency department of the University Hospital of Larissa, Greece, suffering from sternal fractures (SFs). Of these 64 patients, 45 had sustained ISF, while the remaining 19 had SF and additional injuries (intrathoracic and extrathoracic). The files of these 45 patients were further investigating as concerning the mechanism of injury, hospitalization days, morbidity, and mortality.

Results: All the patients had been involved in motor vehicle crashes and most of them were wearing seat belts during the accident (91%). The hospital length of stay (LOS) was 1.85 ± 1.67. All the patients had upon admission chest radiograms, serial electrocardiographs (ECGs), echocardiograms, and cardiac enzyme levels. Two patients had abnormal ECG and abnormal cardiac enzymes which contributed in prolonged hospitalization. However, there was no incidence of cardiac complications or deaths.

Conclusions: ISFs, with normal electrocardiogram, cardiac enzymes, and chest X-ray in the absence of complications, require no further investigation.

No MeSH data available.


Related in: MedlinePlus