Evaluation of the Incidence and Clinical Significance of Myocardial Contusion Following Traumatic Sternal Fracture: Retrospective Analysis of 202 Cases

Abstract

Aims: The objective of this study was to assess the incidence of myocardial contusion after traumatic sternal fracture. Methods: 202 patients with traumatic sternal fractures after blunt chest trauma who were treated at the Department of Traumatology, Medical University of Vienna, Austria, from January 1992 to August 2005 were retrospectively evaluated for signs of cardiac complications. Results: Among all patients only 16 ECG abnormalities were registered within the first 24 hours of hospitalisation. The abnormalities consisted of irregular sinus bradycardia, extrasystole, right bundle branch block, A-V block (I°), signs of right heart exertion, and T-wave changes. Total serum creatine phosphokinase (CK) values and isoenzyme determinations of the MB fraction as well as LDH were initially measured in 188 patients. 45 patients had an increased level of CK-MB initially following trauma. Common ECG abnormalities and enzyme level elevations were observed in only 7 of our patients. Conclusion: Although cardiac complications could not be observed in any of our patients, the presence of myocardiac contusion should be ruled out by performing ECG and evaluation of cardiac enzyme levels after fractures of the sternum. We believe that patients with sternal fractures who show an ECG or enzyme abnormality should be admitted and monitored for at least twenty-four hours after the accident.

Key words

Sternal fractures - myocardiac contusion - ECG abnormality - creatine phosphokinase - isoenzyme determinations

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