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