Sternal fractures occur when there is a blow to the chest. This can be caused by an auto accident, where the driver hits the steering wheel as a result of the impact of the collision, or when the seat belt restraint pulls back on the sternum abruptly. Sternal fractures also can occur when playing contact sports with a direct hit to the chest area. A third cause is from being involved in some type of assault, where someone is hit in the chest.
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If you have a blow to the chest and think you might have a sternal fracture or other injury, seek medical attention immediately. With a blow to the chest, you may need to call an ambulance and be taken to the hospital for X-rays.
Once you arrive at the hospital, X-rays will be taken to determine if you have broken or fractured ribs or a fractured sternum. Other conditions will be tested for as well, such as some type of injury to the heart or surrounding muscles that demands treatment.
Get the results of the x-ray to find out whether you have a sternal fracture.
If tests indicate that you have no fracture or break of the sternum (or the ribs), you will be sent home to treat for the bruising and strained muscles, with a treatment plan of rest and relaxation accompanied by pain medication and ibuprofen.
Once a sternal fracture has been identified, you will be directed to take ibuprofen as an anti-inflammatory and a pain medication. Opt for the mildest prescription pain reliever. You may wish to try Darvocet first and only use Percocet if the Darvocet is ineffective for the pain.
Do not expect to have the injured sternum wrapped or placed in any type of cast as would be done with a fractured arm or leg. It is believed that the best healing occurs when you are able to breathe and move regularly rather than in a restricted manner.
If the fracture is large, surgery could be necessary to stabilise the sternum. This is usually only done if medically necessary to allow breathing and ability for healing. Not many sternal fractures require surgery.
Rest the injured area. You will want to get a few days of bed rest where you support the area as well as you can so that movement is not excruciatingly painful.
For the first two weeks, limit movement as much as possible but start some walking around so that the area heals appropriately. Take the pain medication and ibuprofen regularly.
After a few weeks, you will want to start easing back into normal activity. Your body will be your guide. As you are able to tolerate it, you can start to lift things slowly again, starting with a pound or two and building back up to your normal weight load. The pain medication is useful so that you can tolerate getting back into activity. Just be careful not to irritate the sternal fracture which will cause it to take longer to heal.
Your doctor may recommend physiotherapy. This may help you build back up the strength in your chest muscles, as well as allow for getting back your range of movement that may have become somewhat limited after restricting movement to the area during the initial stages of healing.
Although the healing process can take a long time for complete recovery and absence of pain, the prognosis is generally good for full recovery. Usually there is not a problem with the fractured bone healing.
Tips and warnings
- Sternal fractures are much more common as seat belt usage has increased with legislation. Seat belts are often the cause of sternal fractures (although they prevent much worse injuries from occuring, such as being thrown through the car's windshield).
- Sternal fractures most often occur in car accidents when seat belts are used if the air bag does not deploy. If the airbag deploys, it can help prevent the person from hitting the steering wheel or being injured by the seat belt.
- Pain medication may not be your choice of dealing with the sternal fracture, but it can help you get back into regular movement of the sternal area, and allow you to engage in physiotherapy to enhance the healing process.
- You can't necessarily rely on an x-ray that shows you have no fractured sternum. Fractures are not as easy to see on X-rays. If you still feel intense, sharp pain after a week, you may wish to get a CAT scan that can check more carefully for the fracture.
- Don't be surprised if you have intense pain in your sternum for months after the injury. Sometimes it takes a long time for this type of injury to heal.
- Be careful not to become addicted to the narcotic pain medication you are prescribed. If you sense that you feel the urge to continue pain medication usage after the pain subsides, consult your doctor to get the necessary treatment.