Sternal and T3 vertebral body fractures

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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