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Acil Servise Sternal Fraktür Tanısıyla Başvuran Hastaların Klinik Sonuçlarının Değerlendirilmesi: Retrospektif Bir Çalışma

Year 2026, Volume: 28 Issue: 1 , 36 - 43 , 27.04.2026
https://doi.org/10.24938/kutfd.1764674
https://izlik.org/JA94RU22ZL

Abstract

Amaç: Bu çalışmada, sternal fraktür tanısıyla acil servise başvuran hastaların klinik özellikleri, eşlik eden yaralanmaları, tedavi yöntemleri ve kısa dönem sonuçlarının değerlendirilmesi amaçlandı.
Gereç ve Yöntemler: Bu retrospektif ve kesitsel çalışma, 1 Ocak 2019 ile 31 Aralık 2024 tarihleri arasında bilgisayarlı tomografi ile sternal fraktür tanısı almış 18 yaş ve üzeri hastaları kapsamaktadır. Demografik veriler, travma mekanizmaları, yaralanma türleri, laboratuvar bulguları, tedavi süreçleri ve klinik sonuçlar analiz edildi.
Bulgular: Toplam 114 hastanın %68,4’ü erkekti ve ortalama yaş 53,6±17,9 idi. En sık travma nedeni künt travmaydı (%99,1). Fraktürler en çok sternum korpusunda (%55,3) ve manubriumda (%48,2) görüldü. Eşlik eden en yaygın torasik yaralanmalar kaburga fraktürü (%58,8) ve pulmoner kontüzyon (%35,1) idi. İzole sternal fraktür oranı %28,1’di. Acil servis mortalite oranı %1,8 (2/114) olarak saptanırken, acil servis ölümleri de dâhil olmak üzere toplam 30 günlük mortalite oranı %10,5 (12/114) idi. Mortalitenin, pulmoner kontüzyonu veya multipl yaralanması bulunan hastalarda anlamlı olarak daha yüksek olduğu belirlendi. Göğüs travma skoru ≥5 olan hastalarda mortalite anlamlı düzeyde artmıştı (p=0,029). Hastaların çoğu konservatif olarak tedavi edilmiş, sadece %1,8’ine cerrahi uygulanmıştır.
Sonuç: Sternal fraktürler, özellikle eşlik eden torasik komplikasyonlarla birlikte olduğunda önemli morbidite ve mortaliteye neden olabilir. Yüksek riskli hastaların erken belirlenmesinde travma skorları ve klinik bulguların kullanılması tedavi yönetimini optimize edebilir.

References

  • Meredith JW, Hoth JJ. Thoracic trauma: When and how to intervene. Surg Clin North Am. 2007;87(1):95-118.
  • Klei DS, De Jong MB, Öner FC, Leenen LPH, Van Wessem KJP. Current treatment and outcomes of traumatic sternal fractures—a systematic review. Int Orthop. (SICOT). 2019;43(6):1455-1464.
  • Doyle JE, Diaz-Gutierrez I. Traumatic sternal fractures: a narrative review. Mediastinum. 2021;5:34-34.
  • Odell DD, Peleg K, Givon A, et al. Sternal fracture: Isolated lesion versus polytrauma from associated extrasternal injuriesVAnalysis of 1,867 cases. J Trauma Acute Care Surg. 75(3):448-452.
  • Knobloch K, Wagner S, Haasper C, et al. Sternal fractures occur most often in old cars to seat-belted drivers without any airbag often with concomitant spinal injuries: Clinical findings and technical collision variables among 42,055 crash victims. Ann Thorac Surg. 2006;82(2):444-450.
  • Chen J, Jeremitsky E, Philp F, Fry W, Smith RS. A chest trauma scoring system to predict outcomes. Surgery. 2014;156(4):988-994.
  • Şimşek S, Özmen CA, Onat S. Morbidity and mortality associated with fracture of the sternum due to blunt trauma, by fracture type and location. Radiol Bras. 2022;55(3):167-172.
  • Dongel I, Coskun A, Ozbay S, Bayram M, Atli B. Management of thoracic trauma in emergency service: Analysis of 1139 cases. Pak J Med Sci. 2012;29(1):58-63.
  • Uz İ, Üstsoy E, Özçete E, Özdi̇L A, Çi̇nkooğlu A, Ersel M. Factors affecting discharge of patients with sternal fractures. Ege Tıp Dergisi. 2021;60(1):70-75.
  • Yakar S, Baykan N, Önal Ö, Durukan P. Retrospective analysis of patients with sternal fracture. Turk J Emerg Med. 2021;21(1):20-23.
  • Schulz-Drost S, Krinner S, Oppel P, et al. Fractures of the manubrium sterni: treatment options and a possible classification of different types of fractures. J Thorac Dis. 2018;10(3):1394-1405.
  • Scheyerer MJ, Zimmermann SM, Bouaicha S, Simmen HP, Wanner GA, Werner CML. Location of Sternal fractures as a possible marker for associated ınjuries. Emerg Med Int. 2013;2013:1-7.
  • Oyetunji TA, Jackson HT, Obirieze AC, et al. Associated injuries in traumatic sternal fractures: a review of the National Trauma Data Bank. Am Surg. 2013;79(7):702-705.
  • Harde M, Aditya G, Dave S. Prediction of outcomes in chest trauma patients using chest trauma scoring system: A prospective observational study. Indian J Anaesth. 2019;63(3):194.
  • Perna V, Morera R. Factores pronóstico del traumatismo torácico: estudio prospectivo de 500 pacientes. Cir Esp. 2010;87(3):165-170.
  • Mardani P, Moayedi Rad M, Paydar S, et al. Evaluation of lung contusion, associated injuries, and outcome in a major trauma center in Shiraz, Southern Iran. Smereka J, ed. Emerg Med. Int. 2021;2021:1-5.
  • Choudhary S, Pasrija D, Mendez MD. Pulmonary Contusion. İn: StatPearls [Internet]. StatPearls Publishing; 2024. Accessed May 27, 2025. https://www.ncbi.nlm.nih.gov/books/NBK558914/
  • Ekpe E, Eyo C. Determinants of mortality in chest trauma patients. Niger J Surg. 2014;20(1):30.
  • Brink M, Kool DR, Dekker HM, et al. Predictors of abnormal chest CT after blunt trauma: a critical appraisal of the literature. Clin Radiol. 2009;64(3):272-283.
  • Recinos G, Inaba K, Dubose J, et al. Epidemiology of sternal fractures. Am Surg. 2009;75(5):401-404.
  • Kunhivalappil FT, Almansoori TM, AbdulRahman MS, et al. Management of blunt sternal fractures in a community-based hospital. Marulli G, ed. Surg Res Pract. 2023;2023:1-8.
  • Sybrandy KC. Diagnosing cardiac contusion: old wisdom and new insights. Heart. 2003;89(5):485-489.

CLINICAL OUTCOMES OF PATIENTS PRESENTING TO THE EMERGENCY DEPARTMENT WITH STERNAL FRACTURES: A RETROSPECTIVE STUDY

Year 2026, Volume: 28 Issue: 1 , 36 - 43 , 27.04.2026
https://doi.org/10.24938/kutfd.1764674
https://izlik.org/JA94RU22ZL

Abstract

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.

References

  • Meredith JW, Hoth JJ. Thoracic trauma: When and how to intervene. Surg Clin North Am. 2007;87(1):95-118.
  • Klei DS, De Jong MB, Öner FC, Leenen LPH, Van Wessem KJP. Current treatment and outcomes of traumatic sternal fractures—a systematic review. Int Orthop. (SICOT). 2019;43(6):1455-1464.
  • Doyle JE, Diaz-Gutierrez I. Traumatic sternal fractures: a narrative review. Mediastinum. 2021;5:34-34.
  • Odell DD, Peleg K, Givon A, et al. Sternal fracture: Isolated lesion versus polytrauma from associated extrasternal injuriesVAnalysis of 1,867 cases. J Trauma Acute Care Surg. 75(3):448-452.
  • Knobloch K, Wagner S, Haasper C, et al. Sternal fractures occur most often in old cars to seat-belted drivers without any airbag often with concomitant spinal injuries: Clinical findings and technical collision variables among 42,055 crash victims. Ann Thorac Surg. 2006;82(2):444-450.
  • Chen J, Jeremitsky E, Philp F, Fry W, Smith RS. A chest trauma scoring system to predict outcomes. Surgery. 2014;156(4):988-994.
  • Şimşek S, Özmen CA, Onat S. Morbidity and mortality associated with fracture of the sternum due to blunt trauma, by fracture type and location. Radiol Bras. 2022;55(3):167-172.
  • Dongel I, Coskun A, Ozbay S, Bayram M, Atli B. Management of thoracic trauma in emergency service: Analysis of 1139 cases. Pak J Med Sci. 2012;29(1):58-63.
  • Uz İ, Üstsoy E, Özçete E, Özdi̇L A, Çi̇nkooğlu A, Ersel M. Factors affecting discharge of patients with sternal fractures. Ege Tıp Dergisi. 2021;60(1):70-75.
  • Yakar S, Baykan N, Önal Ö, Durukan P. Retrospective analysis of patients with sternal fracture. Turk J Emerg Med. 2021;21(1):20-23.
  • Schulz-Drost S, Krinner S, Oppel P, et al. Fractures of the manubrium sterni: treatment options and a possible classification of different types of fractures. J Thorac Dis. 2018;10(3):1394-1405.
  • Scheyerer MJ, Zimmermann SM, Bouaicha S, Simmen HP, Wanner GA, Werner CML. Location of Sternal fractures as a possible marker for associated ınjuries. Emerg Med Int. 2013;2013:1-7.
  • Oyetunji TA, Jackson HT, Obirieze AC, et al. Associated injuries in traumatic sternal fractures: a review of the National Trauma Data Bank. Am Surg. 2013;79(7):702-705.
  • Harde M, Aditya G, Dave S. Prediction of outcomes in chest trauma patients using chest trauma scoring system: A prospective observational study. Indian J Anaesth. 2019;63(3):194.
  • Perna V, Morera R. Factores pronóstico del traumatismo torácico: estudio prospectivo de 500 pacientes. Cir Esp. 2010;87(3):165-170.
  • Mardani P, Moayedi Rad M, Paydar S, et al. Evaluation of lung contusion, associated injuries, and outcome in a major trauma center in Shiraz, Southern Iran. Smereka J, ed. Emerg Med. Int. 2021;2021:1-5.
  • Choudhary S, Pasrija D, Mendez MD. Pulmonary Contusion. İn: StatPearls [Internet]. StatPearls Publishing; 2024. Accessed May 27, 2025. https://www.ncbi.nlm.nih.gov/books/NBK558914/
  • Ekpe E, Eyo C. Determinants of mortality in chest trauma patients. Niger J Surg. 2014;20(1):30.
  • Brink M, Kool DR, Dekker HM, et al. Predictors of abnormal chest CT after blunt trauma: a critical appraisal of the literature. Clin Radiol. 2009;64(3):272-283.
  • Recinos G, Inaba K, Dubose J, et al. Epidemiology of sternal fractures. Am Surg. 2009;75(5):401-404.
  • Kunhivalappil FT, Almansoori TM, AbdulRahman MS, et al. Management of blunt sternal fractures in a community-based hospital. Marulli G, ed. Surg Res Pract. 2023;2023:1-8.
  • Sybrandy KC. Diagnosing cardiac contusion: old wisdom and new insights. Heart. 2003;89(5):485-489.
There are 22 citations in total.

Details

Primary Language English
Subjects Health Services and Systems (Other)
Journal Section Research Article
Authors

Emre Dilaver 0000-0002-8100-6046

Abdul Samet Şahin 0000-0001-9512-8741

Serkan Özden 0000-0002-3824-5383

İrem Dilaver 0000-0002-9962-7908

Süleyman Cem Akil 0000-0002-3649-9283

Buket Kaytaz Alkaş 0009-0008-6575-6876

Sinan Paslı 0000-0003-0052-2258

Celal Tekinbaş 0000-0001-9361-9483

Submission Date August 17, 2025
Acceptance Date October 24, 2025
Publication Date April 27, 2026
DOI https://doi.org/10.24938/kutfd.1764674
IZ https://izlik.org/JA94RU22ZL
Published in Issue Year 2026 Volume: 28 Issue: 1

Cite

APA Dilaver, E., Şahin, A. S., Özden, S., Dilaver, İ., Akil, S. C., Kaytaz Alkaş, B., Paslı, S., & Tekinbaş, C. (2026). CLINICAL OUTCOMES OF PATIENTS PRESENTING TO THE EMERGENCY DEPARTMENT WITH STERNAL FRACTURES: A RETROSPECTIVE STUDY. The Journal of Kırıkkale University Faculty of Medicine, 28(1), 36-43. https://doi.org/10.24938/kutfd.1764674
AMA 1.Dilaver E, Şahin AS, Özden S, et al. CLINICAL OUTCOMES OF PATIENTS PRESENTING TO THE EMERGENCY DEPARTMENT WITH STERNAL FRACTURES: A RETROSPECTIVE STUDY. Kırıkkale Uni Med J. 2026;28(1):36-43. doi:10.24938/kutfd.1764674
Chicago Dilaver, Emre, Abdul Samet Şahin, Serkan Özden, et al. 2026. “CLINICAL OUTCOMES OF PATIENTS PRESENTING TO THE EMERGENCY DEPARTMENT WITH STERNAL FRACTURES: A RETROSPECTIVE STUDY”. The Journal of Kırıkkale University Faculty of Medicine 28 (1): 36-43. https://doi.org/10.24938/kutfd.1764674.
EndNote Dilaver E, Şahin AS, Özden S, Dilaver İ, Akil SC, Kaytaz Alkaş B, Paslı S, Tekinbaş C (April 1, 2026) CLINICAL OUTCOMES OF PATIENTS PRESENTING TO THE EMERGENCY DEPARTMENT WITH STERNAL FRACTURES: A RETROSPECTIVE STUDY. The Journal of Kırıkkale University Faculty of Medicine 28 1 36–43.
IEEE [1]E. Dilaver et al., “CLINICAL OUTCOMES OF PATIENTS PRESENTING TO THE EMERGENCY DEPARTMENT WITH STERNAL FRACTURES: A RETROSPECTIVE STUDY”, Kırıkkale Uni Med J, vol. 28, no. 1, pp. 36–43, Apr. 2026, doi: 10.24938/kutfd.1764674.
ISNAD Dilaver, Emre - Şahin, Abdul Samet - Özden, Serkan - Dilaver, İrem - Akil, Süleyman Cem - Kaytaz Alkaş, Buket - Paslı, Sinan - Tekinbaş, Celal. “CLINICAL OUTCOMES OF PATIENTS PRESENTING TO THE EMERGENCY DEPARTMENT WITH STERNAL FRACTURES: A RETROSPECTIVE STUDY”. The Journal of Kırıkkale University Faculty of Medicine 28/1 (April 1, 2026): 36-43. https://doi.org/10.24938/kutfd.1764674.
JAMA 1.Dilaver E, Şahin AS, Özden S, Dilaver İ, Akil SC, Kaytaz Alkaş B, Paslı S, Tekinbaş C. CLINICAL OUTCOMES OF PATIENTS PRESENTING TO THE EMERGENCY DEPARTMENT WITH STERNAL FRACTURES: A RETROSPECTIVE STUDY. Kırıkkale Uni Med J. 2026;28:36–43.
MLA Dilaver, Emre, et al. “CLINICAL OUTCOMES OF PATIENTS PRESENTING TO THE EMERGENCY DEPARTMENT WITH STERNAL FRACTURES: A RETROSPECTIVE STUDY”. The Journal of Kırıkkale University Faculty of Medicine, vol. 28, no. 1, Apr. 2026, pp. 36-43, doi:10.24938/kutfd.1764674.
Vancouver 1.Emre Dilaver, Abdul Samet Şahin, Serkan Özden, İrem Dilaver, Süleyman Cem Akil, Buket Kaytaz Alkaş, Sinan Paslı, Celal Tekinbaş. CLINICAL OUTCOMES OF PATIENTS PRESENTING TO THE EMERGENCY DEPARTMENT WITH STERNAL FRACTURES: A RETROSPECTIVE STUDY. Kırıkkale Uni Med J. 2026 Apr. 1;28(1):36-43. doi:10.24938/kutfd.1764674

This Journal is a Publication of Kırıkkale University Faculty of Medicine.