title: Management of isolated sternal fractures using a practical algorithm.
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.
  
  
  OBJECTIVE
  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.
  
  
  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.
authors.affiliation: Department of Cardiac Surgery, Manchester Royal Infirmary, Manchester, United Kingdom ; Department of Cardiovascular and Thoracic Surgery, University Hospital of Larissa, Greece.
authors.forename: Dimos
authors.initials: D
authors.lastname: Karangelis
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, University Hospital of Larissa, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Bouliaris
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, University Hospital of Larissa, Greece.
authors.forename: Theocharis
authors.initials: T
authors.lastname: Koufakis
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, University Hospital of Larissa, Greece.
authors.forename: Kyriakos
authors.initials: K
authors.lastname: Spiliopoulos
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, University Hospital of Larissa, Greece.
authors.forename: Nicholaos
authors.initials: N
authors.lastname: Desimonas
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, University Hospital of Larissa, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Tsilimingas
keywords: Cardiac contusion; cardiac trauma; sternal fractures
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