We have reviewed 162 consecutive cases of sternal fracture admitted to the Leicester Royal Infirmary over a 10 year period. There were no incidences of cardiogenic shock or arrhythmia developing in patients who had sustained an isolated sternal fracture, irrespective of the aetiology. There were three deaths, three ITU admissions and one arrhythmia, all occurring in patients with severe thoracic injuries, or other associated injury. Our series confirms the observations of other authors, that patients with isolated sternal fractures, especially those sustained by car occupants wearing seatbelts, do not develop myocardial pump failure or arrhythmias as a late or occult phenomenon and can often be discharged home if there is no clinical evidence of cardiac failure and a 12-lead ECG is normal.