Clinical Outcomes of Patients Presenting to the Emergency Department With Sternal Fractures: A Retrospective Study

Objective: This study aimed to evaluate the clinical features, associated injuries, treatment approaches, and short-term outcomes of patients presenting to the emergency department with sternal fractures. Material and Methods: This retrospective cross-sectional study included patients aged 18 years and older who were diagnosed with a sternal fracture via computed tomography between January 1, 2019, and December 31, 2024. Demographics, trauma mechanisms, injury types, lab findings, treatment strategies, and outcomes were analyzed. Results: A total of 114 patients were included; 68.4% were male with a mean age of 53.6±17.9 years. The most common trauma mechanism was blunt trauma (99.1%). Fractures were mostly located in the sternal body (55.3%) and manubrium (48.2%). Rib fractures (58.8%) and pulmonary contusions (35.1%) were the most frequent concomitant injuries. Isolated sternal fractures occurred in 28.1% of patients. Emergency-department mortality was 1.8% (2/114), and overall 30-day mortality was 10.5% (12/114), including ED deaths, significantly higher among those with pulmonary contusions or multiple injuries. A chest trauma score of ≥5 was also significantly associated with increased mortality (p=0.029). Most patients were managed conservatively, with only 1.8% undergoing surgery.Conclusion: Sternal fractures may result in considerable morbidity and mortality, especially when accompanied by thoracic complications. Utilizing trauma scores and clinical findings can assist in identifying high-risk patients and guide treatment decisions.