A retrospective study of blunt chest injuries due to motor vehicle accidents between the years 1990 and 1995 found 9 cases of sternal fracture that had both lateral plain film and thoracic axial CT scans performed. Plain film identified 8 of the 9 fractured sternums. CT scanning was only able to identify 6 sternal fractures. Secondary signs of sternal fracture were only seen in 5 of 9 patients, 3 had retrosternal haematomas and 2 had haematoma of the mediastinum.
Conclusions: (1) plain film is still superior to Axial CT scanning for identification of sternal fracture; (2) retrosternal haematoma, although a specific sign for sternal fracture has low sensitivity (3/9); (3) mediastinal haematoma, a poorly specific sign for sternal fracture also demonstrated low sensitivity.