The sternum, often known as the breastbone, is an important bone at the center of the chest. It protects vital organs like the heart and lungs within the thoracic cavity. This article explains what a fractured sternum is, including its signs, diagnosis, and recovery. Understanding these aspects helps in seeking appropriate medical attention.
Understanding the Sternum
The sternum is a long, flat bone in the middle of the chest, forming the front of the rib cage. It consists of three main parts: the manubrium at the top, the body in the middle, and the xiphoid process at the bottom. This bony structure connects to the ribs via cartilage, providing a protective shield for the heart, lungs, and major blood vessels from external trauma.
The sternum’s design allows for some flexibility, which aids breathing. It serves as an attachment point for various muscles in the chest and upper abdomen, contributing to chest wall stability and function.
Recognizing the Signs and Symptoms
A fractured sternum causes immediate, localized pain. This pain is often described as sharp and intense, worsening with movements like deep breathing, coughing, laughing, or sneezing. Even minor movements of the upper back or arms, such as bending or lifting, can worsen the discomfort.
Tenderness is common upon direct touch or pressure. Swelling and bruising on the chest wall often accompany a sternal fracture. In some instances, a palpable defect or a “stair-step” deformity may be felt along the fracture line, though this is less common for simpler fractures.
Pain can cause shallow breaths, leading to difficulty breathing. This reluctance to cough can increase the risk of chest infections. Sometimes, a clicking or grinding sensation (crepitus) may be felt. These signs indicate the need for prompt medical evaluation.
Medical Diagnosis and Initial Care
Diagnosing a fractured sternum begins with a physical examination. The doctor will assess the chest for tenderness, swelling, bruising, and any visible deformities. This assessment helps understand the injury’s potential extent and any associated concerns.
Imaging tests confirm the diagnosis and evaluate the fracture’s characteristics. A lateral chest X-ray often shows the fracture and any displacement. A CT scan provides a more detailed assessment, visualizing the sternal injury and identifying internal injuries to organs like the heart or lungs.
Initial care focuses on pain management and complication prevention. Pain relief medications alleviate discomfort and enable easier breathing. Rest and activity restrictions prevent further injury. Most isolated sternal fractures heal without the need for surgical intervention.
Healing and Recovery
The healing process for an uncomplicated sternal fracture typically spans 6 to 12 weeks. Pain gradually subsides, though some discomfort can persist for several months. The timeline for full recovery can be longer if surgery was required or if complications arise.
Recovery management involves continued pain control to ensure comfort and facilitate breathing. Activity restrictions are important, including avoiding heavy lifting, strenuous exercise, and contact sports for several weeks. Gentle movement and deep breathing exercises are encouraged to prevent stiffness and reduce the risk of chest infections.
Most sternal fractures heal without issues, but rare complications like non-union (where the bone fails to heal) can occur. A gradual return to normal activities is advised as pain decreases and healing progresses, under medical guidance. This phased approach helps ensure a complete and safe recovery.