The sternum, commonly called the breastbone, is
a vertical bone that runs down the front of the
chest wall, beginning at the front of the collarbone,
and attaches to each of the upper ribs. A sternum
fracture is a break of the bone, in one place or
multiple places.
Causes
Sternum fractures are generally associated with
violent causes such as automobile accidents, but
they can occasionally occur in athletics. For example,
a football player may fracture his sternum if he
receives a blow to the top of the head while he
is bent forward with his head down. The player’s
position causes the blow to be absorbed in the chest,
which can lead to a fracture. A direct blow to the
chest wall can cause a fractured sternum.
Medical Evaluation
There usually are three parts to a medical evaluation:
medical history, a physical examination, and tests
that your doctor may order.
MEDICAL
HISTORY
Your physician likely will ask about your activities,
which may have caused your sternum fracture. You
will probably be asked when the soreness or pain
began. If you have had any prior injuries in the
area, your physician will ask about the treatments
you have tried in the past. Physicians generally
suspect a sternum fracture when the patient is experiencing
pain in the anterior chest wall that increases when
inhaling, and perhaps is having difficulty breathing
as well. Physicians also typically ask about other
conditions, such as diabetes and allergies, and
medications currently being taken. You may also
be asked about your physical and athletic goals
– information that will help decide what treatment
might be best for you in achieving those goals.
Your physician will generally press or
feel around your chest to test the extent of tenderness
you may be feeling. He also will listen for any
crackling sounds that may be coming from the area
as you breathe.
TESTS
X-rays taken from different
angles typically can reveal the location and extent
of your sternum fracture. Often, the view from the
side is most helpful. X-rays will also be taken
to rule out any rib fractures or other injuries
in the area. A CT scan may also be used to get a
better view of the sternum. Also, an EKG may be
done to look for a contusion (bruise) of the heart.
If this is suspected, an electrocardiogram or CT
scan of the chest may be ordered.
