Abstract

Background
Sternal fracture may be associated with myocardial contusion even in patients without associated with significant injuries. The aims of this study are to determine the role of echocardiogram(ECHO) in treatment of sternal fracture and to suggest the indication of ECHO. Material and Method: We reviewed the records of 50 consecutive patients presenting with sternal fracture after blunt chest trauma. The relationships between ECHO, creatine kinase MB isoenzyme(CK-MB), electrocardiogram(EKG) were assessed in reference to myocardial contusion. Results: Twelve patients(24%) had one or more abnormal cardiac tests but only 4(8%) had clinically symptomatic myocardial contusion. Eight(22.9%) out of 35 ECHO studies revealed pericardial effusion which was not associated with the severity of all other associated injuries. The incidence of an abnormal ECHO finding in patients of isolated sternal fracture was similar to that of the patients who suffered multiple injuries. In 4 patients with pericardial effusion, this finding was not associated with any other abnormal tests and was regarded as of no clinical cardiac significance. On the other hand, a myocardial contusion was shown by ECHO study only while EKG and CK-MB tests remained normal in that patients. Conclusion: We suggest that the ECHO should be used as a diagnostic and triage tool in every patient with sternal fracture associated with other injuries. However patients with “benign”epicardial effusion can be discharged as soon as their clinical condition improves regardless of other associate injuries.

• Keywords: Sternal fracture, Myocardial contusion, Echocardiography