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A sternum fracture is considered an immediate life-threatening injury due to the anatomical location of this bone and its close connection to vital organs in the chest. The sternum is a flat bone located in the anterior chest cavity and consists of three parts: the manubrium, the body, and the xiphoid process, which are connected by cartilage. This bone plays an important supporting and protective role, serving as the attachment site for the ribs and clavicles and protecting the heart, major vessels, and lungs from external influences.

The most common cause of sternal fracture is direct trauma, which occurs when the chest strikes the steering wheel of a car during a traffic accident, falls from a height onto protruding objects, or a direct blow to the sternum. In combat situations, sternal fractures can result from blast trauma, when a shock wave impacts the anterior chest wall, or from shrapnel and gunshot wounds. Much less common are compression fractures, which occur when the spine is excessively flexed and the force is transferred through the ribs to the sternum.

The clinical picture of a sternal fracture consists of local manifestations and symptoms caused by possible damage to the intrathoracic structures. The victim complains of sharp pain in the center of the chest, which intensifies significantly with deep inhalation, coughing, sneezing, or any movement of the torso. Examination often reveals localized swelling and hemorrhage in the area of ​​injury, as well as a stepwise deformation upon palpation, indicating displacement of bone fragments. A characteristic sign is crepitus—the crunching sound of rubbing bone fragments, detectable by palpation or auscultation.

Respiratory distress following a sternal fracture can be associated with both pain, which limits chest expansion, and direct damage to the lungs or pleura. The victim breathes shallowly, trying to spare the chest, leading to hypoventilation and increasing hypoxia. In cases of combined injury with rib damage, a floating chest may develop, where a section of the chest wall undergoes paradoxical movements, further exacerbating respiratory failure.

Complications associated with damage to the mediastinal organs pose a particular danger. Sharp bone fragments can injure the pericardium and the heart itself, causing hemopericardium and cardiac tamponade, or damage major vessels, leading to massive internal bleeding. A sternal fracture often results in cardiac contusion, manifested by rhythm and conduction disturbances that can be recorded on an electrocardiogram. Pneumothorax and hemothorax develop when the pleura and lung are damaged by bone fragments and require immediate drainage of the pleural cavity.

First aid for a sternum fracture should be aimed at minimizing the risk of further damage to internal organs and preparing the victim for transportation. The victim should be placed supine on a hard surface, in a semi-sitting position with a bolster under the back, which facilitates breathing and reduces pressure on the chest. It is important to ensure maximum rest, avoiding any unnecessary movements or attempts to change body position. Apply cold to the injured area to reduce swelling and pain, using an ice pack placed over a cloth pad.

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