A broken sternum refers to a break in the breastbone — the long, flat bone that’s located in the center of the chest and connected to the ribs via cartilage. It forms the front of the rib cage, protecting the heart, lungs, and other major blood vessels.
The vast majority of sternal fractures are caused by direct trauma to the chest. This trauma is usually caused by a seatbelt when a person is involved in a car accident.
In addition to road accidents, sternal fractures are caused by:
- falling from a large height
- high-impact sports
- vehicle-to-pedestrian collisions
You’re at a higher risk of experiencing a broken sternum if you:
- have thoracic kyphosis or osteoporosis
- are an older adult
- are postmenopausal
- have been using steroids for a long period of time
When we breathe, the sternum moves continually with the rib cage. However, when you’ve fractured your breastbone, breathing becomes painful.
This pain normally gets worse when taking a deep breath, coughing, or laughing. Because of the muscles attached to the sternum, moving your arms and lifting heavy objects can also be uncomfortable.
It’s important to see a doctor if you suspect you have a sternal fracture, so they can determine if you need surgery and rule out additional injuries.
Because sternal fractures are most commonly a result of trauma, initial treatment is often done by emergency medical professionals. However, once at the hospital, your doctor will take an X-ray called a lateral radiograph to detect a sternal fracture. They may also take a CT scan, but lateral radiographs are the best way to see if you have this particular injury.
It’s important to schedule a follow-up appointment, so that your doctor can monitor your healing and progress.
Your sternal fracture will be treated depending on the severity of the break, how the bone broke, and the exact symptoms you’re experiencing. The most common form of treatment is simply to rest and allow the break to heal.
During this time, ice the chest area to treat both swelling and pain. You can also take over-the-counter pain medication such as acetaminophen (Tylenol) or ibuprofen (Advil).
However, if your pain is severe, you may want to consult with your doctor about pain control.
In rare cases, surgery is required to put the bone back in place.
Most people are able to fully recover from a broken sternum in a few months, the average recovery time being 10 and a half weeks.
Recovery time may be longer time if surgery was required during treatment. To avoid developing a chest infection during recovery, there are a few things you can do:
- take deep breaths regularly throughout the day
- avoid suppressing the need to cough
- avoid taking cough medicine
- support the chest wall while coughing
After you leave the hospital, contact your doctor immediately if you develop a fever, feel short of breath, or start coughing up yellow, green, or bloody phlegm. You’ll also want to contact your doctor if you’re still experiencing severe pain after a period of eight weeks.
You may want to consider physical therapy if, after a long period of recovery, you experience stiffness in your shoulders, arms, and spine that doesn’t go away.
There are both short-term and long-term complications associated with sternal injuries.
The most common short-term complication is chest pain, which can last anywhere from 8 to 12 weeks. This pain will likely prevent you from coughing. When you resist coughing, you fail to clear your natural lung secretions, which can result in a chest infection.
In the case of a broken sternum due to trauma, it’s also possible to bruise the underlying lung tissue or heart. In the long term, you will run into complications if the sternum fails to heal properly.
If that happens, it’s possible to develop what is called pseudarthrosis, or a false joint. This can be painful and may require surgery to correct. Older adults, those with osteoporosis or diabetes, and those on steroids are more likely to develop pseudarthrosis.
Because you most likely aren’t using your arms during recovery, you may also experience pain and stiffness in the shoulder and spine in the weeks after a sternal fracture.
The pain and symptoms associated with a broken sternum should go away within a number of weeks, and it’s important to set up another appointment with your doctor if you don’t feel better. Do what you can to avoid a lung infection and to avoid other complications. In most cases, a full recovery from a fractured sternum is entirely possible.