The Israel Medical Association journal : IMAJ · 2003
Isolated sternal fracture--a benign condition?
СтатьяНазвание и аннотация: Перевод в очереди
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Bar Ilan, Friedman Tal, Rudis Ehud, Shargal Yaron, Friedman Mony, Elami Amir
Аннотация
BACKGROUND: Fractures of the sternum may be associated with major injuries to thoracic organs, with serious consequences.
OBJECTIVE: To assess the hospital course of patients diagnosed with isolated sternal fracture.
METHODS: We reviewed 55 medical records of patients who were admitted with isolated sternal fracture to the emergency department during the period January 1990 through August 1999.
RESULTS: Fifty-one patients were involved in motor vehicle accidents, and 4 sustained the injury as the result of a fall. Lateral chest X-ray upon admission was diagnostic in the majority of these patients (n = 53). Electrocardiography (n = 52) was abnormal in four patients--old myocardial infarction (n = 1), non-specific ST-T changes (n = 3). Cardiac enzymes (creatine-kinase-MB, n = 42) were pathologically elevated in five patients. Echocardiography, performed in patients with ECG abnormalities and/or elevated myocardial enzymes (n = 7), was normal in these patients as well as in another 18 patients. There were no intensive care unit admissions or arrhythmias during the hospital stay, which ranged from 6 hours to 6 days (mean 2.3 +/- 1.3 days, median 2 days).
CONCLUSION: Our findings support the view that patients with isolated sternal fracture and no abnormality in ECG and cardiac enzymes during the early hours after injury are expected to have a benign course and can be discharged home from the emergency room within the first 24 hours.
OBJECTIVE: To assess the hospital course of patients diagnosed with isolated sternal fracture.
METHODS: We reviewed 55 medical records of patients who were admitted with isolated sternal fracture to the emergency department during the period January 1990 through August 1999.
RESULTS: Fifty-one patients were involved in motor vehicle accidents, and 4 sustained the injury as the result of a fall. Lateral chest X-ray upon admission was diagnostic in the majority of these patients (n = 53). Electrocardiography (n = 52) was abnormal in four patients--old myocardial infarction (n = 1), non-specific ST-T changes (n = 3). Cardiac enzymes (creatine-kinase-MB, n = 42) were pathologically elevated in five patients. Echocardiography, performed in patients with ECG abnormalities and/or elevated myocardial enzymes (n = 7), was normal in these patients as well as in another 18 patients. There were no intensive care unit admissions or arrhythmias during the hospital stay, which ranged from 6 hours to 6 days (mean 2.3 +/- 1.3 days, median 2 days).
CONCLUSION: Our findings support the view that patients with isolated sternal fracture and no abnormality in ECG and cardiac enzymes during the early hours after injury are expected to have a benign course and can be discharged home from the emergency room within the first 24 hours.