Forecast

In most cases, fractures of the sternum heal within a few weeks without complications. In rare cases, pseudoarthrosis may develop.

Duration

A fracture of the sternum (sternal fracture) occurs very rarely, especially when the sternum has been subjected to enormous mechanical stress, for example in a car accident in which the rider was thrown onto the handlebars with his chest, or in a riding accident. The problem with a sternum fracture is that the sternum can neither be plastered nor splinted. Accordingly, the patient must take great care not to put too much strain on the sternum under any circumstances.

If the sternum has been fractured very severely, it may be necessary to perform surgery in which a plate or splint is inserted into the sternum to stabilize it. The duration of a breastbone fracture always depends on various parameters, first of all the age of the patient, the severity of the fracture and the patient’s health. The older a patient is, the worse and slower a fracture grows together.

Patients who are very overweight will in all probability have to struggle with the sternum fracture for a longer period of time, as the sternum is automatically subjected to more stress than in slim patients, especially in women with a strong bust. In fit, young patients, it is said that the duration of a sternum fracture is approximately 2 months. Only then will the bone have grown back together enough to bear small loads such as jogging or cycling (important: no weight lifting or heavy loads) without complications and pain.

The time until complete freedom from pain and until the patient is able to put normal weight on the sternum is about half a year for young patients. Before this time, it is very important that during the complete duration of the sternum fracture, the sternum is always loaded as little as possible, otherwise faulty bone growth can occur and in the worst case, the duration can only be prolonged. If an operation had to be carried out for the sternum fracture, the duration of the sternum fracture is indirectly extended, as the plate or splint in the sternum usually has to be surgically removed again as soon as the bone has grown together completely.

Depending on bone growth, this can take up to a year. Without surgery, however, the sternum fracture should have healed very well after six months and should not cause the patient any more problems. Compared to the fracture of the arm, the sternum fracture is not a “classic” fracture, as a plaster cast or other supporting aids are not used.

In order to heal a sternum fracture, one must rely on other aids. In most cases, a sternum fracture is not operated on, only in particularly severe cases, for example if the sternum has been displaced, is surgery advisable. In most cases, however, one tries to treat the sternum fracture with much rest and little stress.

This healing of the sternum fracture is usually very successful as long as the patient follows the doctor’s instructions. The most important thing is to treat the symptoms. The healing of the sternum fracture is usually unproblematic, but the symptoms must be treated with painkillers.

On the one hand, the analgesics help to relieve the shortness of breath, since despite the pain that actually occurs when breathing, breathing can be increased and made easier again. On the other hand, the analgesics also help to keep the pain caused by the fracture under control. However, in order to achieve complete healing of a sternum fracture, pure pain therapy is not sufficient.

Breathing therapy must also be carried out with the patient so that the patient inhales deeply and evenly despite pain or discomfort, otherwise a complete healing of the symptoms is not possible. In addition, a professional physiotherapy should be carried out, which on the one hand strengthens the back muscles to counteract a bad posture and on the other hand supports the healing of the sternum fracture. In order to promote the healing of the sternum fracture it is also important not to overstrain yourself.

Lifting heavy objects is absolutely counterproductive and should be avoided. Sports that place a particular strain on the sternum, such as weight training, should be avoided until the sternum has completely healed. This may take longer than 6 months.

It is also important not to hinder the healing process by exuberance. The surrounding tissue and bone need at least 6-8 weeks to heal properly. In addition, it is not possible to say that the bone fracture has healed after 8 weeks for everyone.

Older people in particular have poorer bone growth and therefore it often takes longer for a sternum fracture to heal completely. It is also important to monitor the healing process. It is also important to monitor the healing process, as false joints (pseudoarthrosis) can occur during the fusion of the sternum.

Normally, the ribs are connected to the sternum, but it is possible that an additional joint is formed as a result of a sternum fracture, which then impairs healing. It is therefore important to have X-rays taken at regular intervals during the healing of the sternum fracture to avoid any problems. Should one of the above-mentioned complications occur, surgery is the only way to avoid permanent damage.

During surgery, metal plates are usually inserted into the sternum to stabilize it and promote healing. These plates can be removed after months or years if necessary, but can also remain in the sternum as long as they do not cause pain. In most cases, however, the actual problem is not the sternum fracture itself, but rather the secondary complications.

A sternum fracture is almost always accompanied by shortness of breath and can even lead to heart problems. In order to achieve complete healing, it is therefore important to consider not only the fracture itself but also the other complaints. A complete cure can therefore only be said to have been achieved if the shortness of breath has been adequately treated, i.e. if breathing exercises have been performed and the pain medication has been dosed high enough so that the patient can breathe in without any problems.

In addition, an ECG should be taken to check the functioning of the heart and to exclude possible damage. Overall, an otherwise healthy patient should have recovered after about 8 weeks and no further complications should occur. Nevertheless, it is important to note that an already fractured sternum will always be more susceptible and that even with good healing without complications, excessive stress on the sternum should be avoided to prevent a new fracture.

However, if the grace period is observed and the sternum is not put under too much strain, complete healing is very likely. In the case of an uncomplicated sternum fracture, the affected person is usually put on sick leave for at least two weeks. The pain usually lasts much longer. If there is a complicated sternum fracture with injured neighbouring structures, such as a rib injury, the sick leave can last considerably longer. If the job consists of heavy physical work, the sick leave can be considerably longer.