What Are the Treatment Options for Sternum Fractures?

Chest wall trauma can involve the sternum—the flat, elongated bone located at the center of the anterior thoracic cage—and while sternal fractures are relatively uncommon, they often signal significant force exposure, such as from motor vehicle collisions, direct blows, or cardiopulmonary resuscitation (CPR). Management is primarily conservative, with surgical intervention reserved for select cases.

Most sternal fractures—particularly non-displaced or minimally displaced ones—are treated nonoperatively. This includes analgesia (often NSAIDs or short-term opioids for acute pain control), activity modification to avoid chest wall strain, and respiratory support to prevent complications like atelectasis or pneumonia. Patients are advised to avoid heavy lifting, vigorous upper-body movement, and contact sports for 6–8 weeks to allow for bony union, which typically occurs within 8–12 weeks.

Surgical fixation becomes necessary in cases of marked displacement (>1 cm), rotational instability, persistent nonunion, or when associated injuries—such as flail chest, major vascular injury, or cardiac contusion—complicate recovery. Modern techniques commonly employ titanium plates and screws via a midline incision, offering rigid stabilization that facilitates earlier mobilization and reduces chronic pain risk. Postoperative care includes close monitoring for wound infection, hardware-related complications, and pulmonary function assessment.

Regardless of treatment approach, multidisciplinary follow-up is essential. Pulmonary rehabilitation, physical therapy focused on safe breathing mechanics and posture correction, and timely imaging (e.g., CT scan) to assess healing progression help optimize functional outcomes and minimize long-term morbidity such as chronic sternal pain or impaired chest wall mechanics.