Sternum fracture
Synonyms in the broadest sense
Fracture of the sternum, fracture of the sternum
English: sternal fracture, fractured sternum
definition
The sternum fracture is a fracture of the sternum (Sternum fracture). The Sternum sits in front of Rib cage and serves as a starting point for most of the ribs. This close proximity to the Ribs it is understandable that if the sternum breaks, the ribs can also be involved. The costal cartilage can also burst.
Figure rib cage
- 1st rib
- 12th rib
- Breastbone / sternum
- Ribs - sternum - joint
The cartilage part of the rib is blue.
root cause
The most common is direct violence on the sternum the cause of the fracture. It is particularly typical of injuries after a car accident.
Also Sports injuries may be the basis. The breastbone lies unprotected on the rib cage, directly under the skin. It is generally deformed backwards. That’s right behind the breastbone heart it can be crushed.
The Fault line mostly runs horizontal. The sternum breaks transversely at an almost predestined point, namely the seam between the sternum body and the so-called "handle" (Manubrium Sterni).
Symptoms
The fracture is very sensitive to pressure. Originally, the non-fractured sternum is very sensitive to pain.
The pressure to the back causes breath-dependent pain. Rib fractures or rib bruises and cartilage bursts of the costal cartilage are also often combined with the sternum fracture / sternum fracture.
Also read our article: Sternum pain
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diagnosis
A lateral x-ray of the chest is essential, as this is the only way to adequately assess the sternum. If the results of the X-rays can a Ultrasound examination help with diagnosis. Also a CT (Computed tomography) des Sternum may be necessary in exceptional cases.
To a bruise of Heart to be able to exclude is the creation of one EKGs required. By means of a Blood collection cardiac enzymes are also determined for this purpose.
therapy
In the therapy of the sternum fracture one can either use a conservative or operational Choose form of treatment.
Depending on fracture however, it is mostly one conservative therapy sufficient.
On the other hand, it should be a break with very severe pain, Breathing problems and Displacements of the fragments act, you better choose that operative form of treatment.
If necessary, however, surgery can also occur after conservative treatment because complications have occurred.
A common one complicationthat requires surgical treatment is here the Pseudoarthrosis. This is one insufficient bone structure at the fracture siteresulting in a moving discontinuity of the break point. Hence it is also known as False joint.
Conservative therapy:
The main aim of conservative therapy is to protect the body and not put any further strain on the fracture site.
On the other hand, there is less use of Plaster of Paris, splints, bandages or similar. Against the pain come here too Painkiller for use. In addition, you can be targeted and gentle physiotherapy deploy.
Despite the mostly conservative therapy, there is an inpatient admission because the accompanying damage must be excluded.
The most important accompanying damages include Injury to the lungs, of the heart or Cardiac arrhythmias.
The patient must therefore be properly examined, monitored and controlled with appropriate diagnostics, such as X-rays, CT, Heart echo and EKG.
Operative therapy:
Most of the cases of a broken sternum are straight breaks. These usually have to Not operated on and heal by themselves.
But there is one postponed (dislocated) fracture or a multiple break before so got to surgery to be performed. First, a general anesthetic performed before by a Metal plate the fragments are fixed together again so that they grow together again properly. The plate is attached to the bone with screws and can, but does not have to, be removed after a few months or years.
Healing time
The healing time for a sternum fracture varies from case to case. As in most cases, is it a smooth one? fracture from upper part (Manubrium sterni) or des Main part (Corpus sterni) so the break heals by itself out. The person concerned has to be very careful about his / her posture so that the sternum just grows back together. The healing time of the bony structures is then usually 6 to 8 weeks.
That grows Sternum If they are not optimally back together again and a corrective operation has to be carried out, the healing time is extended. Often the used plate after some time surgically removed again so that the affected person has to be subjected to an additional operation.
As a rule, however, should after about half a year no more complaints and the patient should be able to exercise normally again.
Complications of the sternum fracture
A sternum fracture usually heals without any problems.
The complications can be found in Accompanying injuries and Healing disorders organize.
Healing disorders:
A very common complication here is Pseudoarthrosis.
In pseudoarthrosis there is one Disruption of reconstruction the bone structure.
The breaking point works discontinuous and can even be moved more or less movably. Therefore, the pseudoarthrosis is often called a "False joint“.
The site can be completely unstable. So it should be a Early surgery come to fix the problem with screws and plates.
The cause of the pseudoarthrosis usually lies in the insufficient protection of the patient. But it can also be due to the fracture itself.
For example, poses a problem Soft tissue that is still in the fracture gap.
It can also get through Injury to vessels also to one Circulatory disorder come.
Other causes lie in the Previous illnesses of the patient.
A vascular disease in the patient can also lead to a Reduced blood flow to the tissue come, which can affect the healing of the fracture.
There are also bone structure disorders such as the osteoporosis (Bone loss).
Also one Diabetes disease (Blood sugar disorder) and diseases of the Immune system can lead to impaired healing.
Another problem can also be a Infection of the bone be yourself what you then call Osteomyelitis designated.
On the other hand, the wound itself is more often infected due to unclean work on the wound.
Concomitant injuries:
The trauma to the sternum fracture can also damage the heart. This can be an injury to the heart tissue (also annoy, Vessels) or cardiac arrhythmias can be triggered.
The rhythm disturbances must then be treated and monitored separately. In addition, they naturally worsen the prognosis.
In addition, the lungs can also be injured, leading to breathing disorders and aspiration (this leads to the penetration of foreign bodies or fluid into the lungs) can lead.
If the lung membrane is injured by fragments or by trauma, a so-called pneumothorax can also occur. In the case of a pneumothorax, the negative pressure between the lung membrane and the lungs dissolves and air from outside can penetrate through the hole in the lung membrane.
If the air can no longer escape, which is called tension pneumothorax, life-threatening pressure is exerted on vessels in the chest and heart.
Bleeding can also occur as a result of injuries to the vessels during the trauma or as a result of fragments. Depending on the size of the vessel, it can lead to profuse internal bleeding.
Surrounding nerves can also be injured.
Another concomitant injury results from injuries to the ribs, but also to the vertebral bodies, which also worsens the prognosis.
Long-term consequences of a sternum fracture
The consequences of a broken sternum are sometimes still felt by those affected for years, or even lifelong noticed. Since that Sternum occupies a central position in the upper body and via the Collarbone with the shoulder connected, every movement with the arms, shoulders or head arrives at this bone. Even with the Ribswho are at the breathing move, the sternum is in contact.
Those affected often complain years of pain when lifting moderately heavy objects or when making certain arm movements. Depending on the profession, this has an impact on the ability to work.
Since a sternum fracture usually does not have a splint or plaster cast and the fracture has to heal on its own, it rarely occurs not optimal coalescence of the bone. The patient notices this because he has a hump on it Sternum can feel. This is known as False joint (Pseudoarthrosis). In most cases this is harmless and does not require any further therapy. However, this makes the Rib cage less stable and the performance of the person affected is limited depending on the extent.
Is the Instability but too high or the patient suffers from unbearable pain, must have a surgery be considered in which the Sternum and possibly stabilized by a plate.
The injuries caused to others are also among the long-term effects bone or organs are thrown. These include Broken ribs, Vertebral fractures or damage to lung and heart. This may then result in certain circumstances Cardiac arrhythmias and difficulty breathing.
Sternal fracture in children
The childlike skeleton differs considerably from that of an adult. Since children also often very physically active this leads to a tendency to frequent bone fractures. However, the sternum fracture is rarely found in children.
In the case of sternum fractures which occur in childhood, it is interesting that the cause differs from that in adults. If direct violence is the main cause of a sternum fracture in adulthood, it is indirect violence the most common reason for a fracture of the sternum in children. Especially when the Child's trunk strongly bent a sternum fracture can occur. The symptoms of a child's sternum fracture tend to be the same as in an adult person. It should be noted, however, that children suffer from considerable pain localize worse can.
Treatment for a sternum fracture in a child is usually done conservative. Only when the two bone fragments differ greatly is one surgical measure necessary.
personal injury compensation
The amount of compensation for pain and suffering for a sternum fracture always refers to the Individual case and depends on the circumstances of the Cause of the accident. Often it concerns with the cases in which it comes to compensation for pain and suffering due to a broken sternum traffic accidents.
The compensation for pain and suffering is made up of various factors. On the one hand, this includes compensation for pain and suffering, which is seen as "reparation" for the pain suffered by the person concerned. Here it is difficult to decide how high the sum should be, since pain cannot be paid for. The patient often has lifelong pain with certain movements due to the long-term effects. Here there is the option of accepting the compensation for pain and suffering offered and foregoing further payments, or the option is selected Compensation for long-term consequences to acquire. But then it does direct compensation for pain and suffering lower off.
In a traffic accident, there is often not a single injury, but several injuries in addition to a sternum fracture Fractions and or Bruises get together. In addition to the Sternum the Ribs, the Collarbone or the organs in the Rib cage, so lung and heart, damaged. This affects the amount of compensation for pain and suffering.
Also the Failuresthat are in household or at the Gainful employment are taken into account. These are usually between 1000 and 2000 € each. In addition, the culprit must contribute to the costs of medication, inpatient stays and therapy.
All in all, in such a case, if one or more Broken ribs and Bruises In addition, 4000 to 15000 € compensation for pain and suffering should be expected.
