Citation

Ramgopal S, Shaffiey SA, Conti KA. J. Pediatr. Surg. 2018; ePub(ePub): ePub.

Affiliation

Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine; Children's Hospital of Pittsburgh, Pittsburgh, PA, United States.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.jpedsurg.2018.08.040

PMID

30274707

Abstract

BACKGROUND/PURPOSE: Sternal fractures are rare in children. The purpose of this series is to document traumatic findings in pediatric patients with sternal fractures at a Level 1 trauma center. STUDY DESIGN: We reviewed the charts of patients with radiologically confirmed sternal fractures from a trauma database at a pediatric Level 1 trauma center between January 1, 2000 and December 31, 2015. We report mechanisms of injury, associated injuries, complications, and outcomes associated with sternal fractures.

RESULTS: Over the 16-year period, 19/25,781 (0.07%) admitted patients had radiologically confirmed sternal fractures. 15/19 (78.9%) patients were male. The median age was 14 years, with interquartile range 10-16 years. 7/19, (36.8%) were sustained owing to motor vehicle accidents. Associated injuries included substernal hematoma (n = 6), pulmonary contusion (n = 4), vertebral injury (n = 2), rib fracture (n = 4), intraabdominal injury (n = 3), pneumothorax (n = 3), long bone injury (n = 3) traumatic brain injury (n = 2), hemothorax (n = 2), pneumomediastinum (n = 2) and cardiac contusion (n = 1).

CONCLUSIONS: In this series, pediatric sternal fractures were caused by high velocity mechanisms and had significant comorbidity. While patients with isolated sternal fractures may be candidates for emergency department discharge, a thorough evaluation should be performed in children with sternal fractures to identify concurrent injuries. LEVEL OF EVIDENCE: Level IV.

Copyright © 2018 Elsevier Inc. All rights reserved.

Language: en

Keywords

Cardiac contusion; Children; Hemothorax; Injury; MVA; Pediatric; Pneumomediastinum; Pneumothorax; Trauma