Sternal and T3 vertebral body fractures

Case contributed by Dr Henry Knipe

Presentation

MVA, driver, seat belt marks on anterior chest, very tender sternum.

Patient Data

Age: 75 years
Gender: Female
CT

Thoracic Spine

Oblique, minimally displaced fracture through the body of the sternum. Fracture through the right anterolateral inferior corner of the T3 vertebral body (better seen on thin axial slices). 

Case Discussion

Seatbelts have reduced the mortality from road traffic trauma significantly since their introduction. However, they do present with a pattern of injuries depending on whether two-point (lap) or three-point (lap and chest) seatbelts are used.

In the chest a typical pattern includes: sternal fractures, cardiac contusion and upper thoracic spine fractures +/- rib fractures. 

Cardiac contusions are often clinically and almost always radiologically silent. Troponins and ECGs can be used to assess for this injury, which is often associated with sternal fractures. 

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Case information

rID: 26332
Case created: 13th Dec 2013
Last edited: 11th Oct 2017
Tag: trauma
Inclusion in quiz mode: Included

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