Sternal fractures are frequent among polytraumatised patients following high deceleration velocities in a severe vehicle crash K. Knobloch a,c,1, * , S. Wagner a,1 , C. Haasper a , C. Probst a , C. Krettek a , P.M. Vogt c , D. Otte b , M. Richter a a Trauma Department, Medical School Hannover, Germany b Accident Research Unit, Medical School Hannover, Germany c Plastic, Hand and Reconstructive Surgery, Medical School Hannover, Germany Accepted 3 July 2007 Injury, Int. J. Care Injured (2008) 39, 36—43 www.elsevier.com/locate/injury KEYWORDS Sternal fracture; Injury; Crash; ISS; Polytrauma Summary Introduction: Sternal fractures are a rare entity. We hypothesised that a sternal fracture is an indicator of injury severity following traffic accidents. Methods: Analysis of technical indicators of the collision, preclinical and clinical data of patients with sternal fractures from 1985 to 2004 among 42,055 injured patients assessed by an Accident Research Unit. Results: Only 267/42,055 patients (0.64%) suffered a sternal fracture within the 20- year period. Soft tissue bruises are most often concomitant injuries (55%), followed by cervical spine injuries (23%), multiple rib fractures (14%) and lung injuries (12%). Eighteen percent of patients were polytraumatised, with 11.2% dying at the scene, 2.3% in hospital. Deceleration velocity (DV) was significantly correlated with injury severity score (ISS, r 2 = 0.92, y = 0.408x À 4.1573) as with maximal abbreviated injury scale (MAIS, r 2 = 0.81). Patients suffering a sternal fracture being polytraumatised had significantly higher deceleration velocity (60 Æ 17 km/h versus 37 Æ 16 km/h [37.3 Æ 10.6 mph versus 23 Æ 9.9 mph], p = 0.0001). Patients dying with a sternal fracture had a significant higher deceleration velocity (61 km/h, 37.9 mph) versus those surviving (38 km/h, 23.6 mph, p = 0.0001). Regarding the vehicle type, the majority occurred after car accidents in 0.81% (251/31,183 patients), followed by * Corresponding author at: Plastic, Hand and Reconstructive Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Tel.: +49 511 5320; fax: +49 511 532 8890. E-mail address: kknobi@yahoo.com (K. Knobloch). 1 These authors contributed equally to this work. 0020–1383/$ — see front matter # 2007 Elsevier Ltd. All rights reserved. doi:10.1016/j.injury.2007.07.007 RETRACTED