True or myth? sternal fractures and aortic rupture - a twenty year study

Aim of the study: To determine the relation between sternal fracture and aortic rupture between Nosocomial and Necrotomic population. Material and Methods: It is a two different group study. Patients admitted with sternal fracture (Nosocomial population NOP) and Necrotomic population NEP. It is a twenty year study. The NOP study includes 134 patients with sternal fracture diagnosed and admitted in the department of Thoracic Surgery of Nicaea –Greece, during a twenty year period. The NEP study includes530 sternal fractures registered at Medical Examiners (Forensic) Department of Piraeus – Greece, 376 males and 154 females, age from 1-93 years (m.ag 47,68), during a twenty year period. Results: Result Nop study: Noaortic rupture registered. No aortic rupture was found related to sternal fracture. Sternal fracture as an isolated injury has a better prognosis compared to those with associated injuries. The management of sternal fracture is usually conservative with a good outcome, provided early diagnosis and treatment of concomitant injuries is offered from a well-trained and experienced medical team. Result NEP Study: Sternal fracture is related to aortic rupture. Seventy two cases to 530 demonstrated coexistence sternal fracture and aortic rupture (13,58%). Themaincauseis traffic accidents. High alcohol blood levels was found at 153 to 530 cases (28,87%). The male population 133/153(86,93%), The male population (376) outnumber to female (154). Conclusion: Sternal fracture absorbs energy at the frontal thoracic wall protecting the great vessels, the heart and the lungs. When the energy is huge the sternal fracture can’t absorb all the energy, so aortic rupture takes place and cause death. This means that when see patient with sternal fracture at the hospital likely no aortic rupture will happen. It is more wise to look for associated injuries which increase significant morbidity and mortality.