What is Sternal Fracture

Sternal fracture is a break in the bone in the center of your chest (sternum or breastbone). This fracture is not dangerous unless there is also an injury to your heart or lungs, which are protected by the sternum and ribs.

What are the causes?

This condition is usually caused by a forceful injury from:

• Motor vehicle collisions. This is the most common cause.
• Contact sports.
• Physical assaults.

You can also have a sternal fracture without having a forceful injury if the bone becomes weakened over time (stress fracture or insufficiency fracture).

What increases the risk?

You may be at greater risk for a sternal fracture if you:

• Participate in direct contact sports, such as football or wrestling.
• Work at elevated heights, such as in construction.

Other risk factors for a stress or insufficiency sternal fracture include:

• Being female.
• Being a postmenopausal woman.
• Being age 50 or older.
• Having osteoporosis.
• Having severe curvature of the spine.
• Being on long-term steroid treatment.

What are the signs or symptoms?

Symptoms of this condition include:

• Pain over the sternum.
• Pain when pressing on the sternum.
• Pain that gets worse with deep breathing or coughing.
• Shortness of breath.
• Bruising.
• Swelling.
• A crackling sound when taking a deep breath or pressing on the sternum.

How is this diagnosed?

This condition is diagnosed with a medical history and physical exam. You may also have imaging tests, including:

• CT scan.
• Ultrasound.
• Chest X-rays that are taken from a side view.

Your health care provider may check your blood oxygen level with a pulse oximetry test. You may also have repeated electrocardiograms (ECGs) to make sure that your heart has not been injured. You may also have a blood test to check for damage to your heart muscle.

How is this treated?

Treatment depends on the severity of your injury. A sternal fracture without any other injury (isolated sternal fracture) usually heals without treatment. You may need to limit (restrict) some activities at home and take medicine for pain relief.

In rare cases, you may need surgery to repair a sternal fracture that continues to cause severe pain or a sternal fracture that involves bones that have been moved out of position considerably (displaced fracture).

Follow these instructions at home:

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Rest at home. Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• If directed, apply ice to the injured area:
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• Do not lift anything that is heavier than 10 lb (4.5 kg) until your health care provider says it is safe.
• Do not drive or operate heavy machinery while taking prescription pain medicine.
• Do not use any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. If you need help quitting, ask your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• Your pain medicine is not helping.
• You continue to have pain after several weeks.
• You develop a fever.
• You develop a cough and you have thick or bloody mucus (sputum).

Get help right away if:

• You have difficulty breathing.
• You have chest pain.
• You have an abnormal heartbeat (palpitations).
• You feel nauseous or you have pain in your abdomen.