The sternum, commonly known as the breastbone, is a central part of the chest. While the sternum is a robust structure, it is indeed possible for it to sustain a fracture under specific circumstances. This type of injury, though not common, typically requires a significant amount of force.
The Sternum’s Structure and Susceptibility
The sternum is a flat, dagger-shaped bone positioned in the middle of the chest. It serves as a protective shield for vital organs such as the heart, lungs, and major blood vessels located behind it. This bone is comprised of three distinct parts: the manubrium at the top, the body in the middle, and the xiphoid process at the bottom.
The sternum connects to the ribs through cartilage, which provides some flexibility to the chest wall. This cartilaginous connection allows the sternum to absorb certain impacts. Despite its inherent strength and role in safeguarding internal structures, the sternum is not invulnerable and can fracture when subjected to substantial direct trauma.
Causes of Sternum Fractures
Sternum fractures primarily occur from direct, high-impact forces applied to the chest. The most frequent cause is blunt force trauma sustained during motor vehicle accidents, often from the chest striking a steering wheel, dashboard, or seatbelt. Sports injuries involving direct contact, such as powerful tackles, or falls from significant heights can also fracture the sternum.
In less common instances, a sternum fracture can result from severe, prolonged coughing fits, especially in individuals with weakened bones. Cardiopulmonary resuscitation (CPR) compressions, while life-saving, are another known cause due to the concentrated pressure exerted on the chest. These fractures are more prevalent in older patients, whose chest walls are less elastic.
Identifying a Sternum Injury
Identifying a sternum injury involves recognizing signs and symptoms. Localized pain directly over the breastbone is a common indicator. Pain intensifies with movements like deep breathing, coughing, or sneezing, as these actions strain the chest wall. The injured area may also feel tender to the touch, suggesting tissue damage.
Visible signs include swelling and bruising around the sternum, appearing shortly after injury. Some individuals may describe a “grinding” or “creaking” sensation, medically termed crepitus, occurring when fractured bone ends rub. In severe cases, a visible deformity or “step” may be present along the sternum, indicating a displaced fracture.
When to Seek Care and Understanding Sounds
Seek prompt medical attention if a sternum fracture is suspected, especially with severe pain, difficulty breathing, or visible chest deformity. Medical professionals typically perform a physical examination and may order diagnostic imaging, such as a lateral chest X-ray or a computed tomography (CT) scan, to confirm the fracture and assess its extent. A CT scan is the preferred diagnostic method.
It is important to differentiate between the sounds of a sternum fracture and other common chest noises. Benign popping or cracking sounds in the chest are frequently associated with joint movement, such as the costochondral joints where ribs meet cartilage. These sounds are generally harmless and are distinct from the grinding sensation accompanying a fractured sternum. Treatment for sternum fractures involves rest and pain management, allowing the bone to heal naturally over several weeks.