The sternum is also known as the breast bone. Direct trauma or impact can cause a contusion or in more severe cases a sternum fracture may occur.
On this page:
- Bruised sternum explained
- Sternum fracture explained
- Sternoclavicular sprain
A bruised sternum, or sternum contusion as it is also known, occurs after an impact to the sternum or breastbone. This most frequently occurs after road traffic accidents, although collision sports and those with hard balls or rackets etc can also impact the sternum. From this injury the front of the chest will be painful and there may be difficulty breathing.
Symptoms of a bruised sternum
Symptoms include pain on the breastbone following impact. The patient will feel tenderness at the front of the chest over the bone and breathing may be painful. Coughing and sneezing are also likely to reproduce pain and bruising may appear later.
If the pain is severe seek medical attention as soon as possible. A doctor will perform a full examination and may order X-rays which can confirm that there are no fractures to the sternum or the ribs. Treatment of a bruised sternum requires rest for 2-4 weeks to allow the bone to heal. Ice and anti-inflammatory medication may be advised by the doctor to help ease pain and inflammation.
A sternum fracture is a break to the breastbone. A sternal fracture is most often caused by a direct impact to the bone, at the front of the chest. This is most frequent in road traffic accidents. There will be sharp chest pain at the front of the body and bruising may appear. The injury will need to be assessed and monitored to ensure no further damage is made.
Sternum fracture symptoms
Symptoms of a fractured sternum include a sudden onset of pain at the front of the chest after an impact or fall of some kind. Pain is usually well localised and does not radiate. It will be very tender to touch the fracture area and bruising may start to appear after a few hours. Up to 20% of patients may demonstrate breathing difficulties.
Fractured sternums most frequently occur during road traffic accidents. A fractured sternum may also occur during chest compression as performed during CPR (cardiopulmonary resuscitation). Fractures of the breastbone may also happen with considerably less force and have been seen in golfers and weightlifters previously. Older people with Osteoporosis may also be more at risk.
Whilst a fracture is a common injury which is often straightforward to treat, a sternal fracture should be examined thoroughly and put under observation for other complications. These may include pulmonary and cardiac contusions (bruising of the lungs or heart) or damage to the aorta (main artery from the heart). If the fractured part of the bone has been displaced, this is more likely to cause further complications.
Treatment of a sternum fracture which has not been displaced generally involves rest and the use of painkillers or anti-inflammatory medications. If the bone fragment has become displaced, a surgical procedure may be required to re-align the two bone pieces and possibly fix them with pins or screws.
The collarbone connects to the sternum or breastbone in the middle of the chest at the top. If the shoulder is subjected to a hard impact, this joint (known as the sternoclavicular joint), can become injured. There will be pain located on the joint which may spread into the shoulder. Medical help should be consulted to check there is no further damage to blood vessels in the area.
Symptoms will include pain when pressing in specifically at the sternoclavicular joint where the collarbone meets the sternum. Pain may radiate into the shoulder and it is likely there will be a visible bony lump over the joint.
Causes & anatomy
The clavicle or collar bone connects to the sternum or breastbone in the middle of the chest at the top. If the shoulder is subjected to a hard impact this joint can become damaged. It must be said however that this is a very rare injury, but if it does occur and is quite bad you should seek medical help because the bones are dangerously close to important blood vessels.
Treatment of sternoclavicular Injuries
Rest. If the injury is not severe then there is little else they can do. The athlete should be able to return to sport within a few weeks but pain may still be present for a few months.
A professional therapist can determine how bad the injury is and advise on when it is OK to return to sport. They may do a CT scan of the joint and if it is bad you could be confined to a hospital due to the risk of damaging blood vessels. A sternoclavicular injury will not always show up on an X-ray. An operation called a clavicle resection is a possibility. However, it is reported that few Surgeons will attempt it and it is only 50% successful.