American Board of Surgery Qualifying Exam (ABS QE) Practice Test

A sternal fracture may lead to which type of injury?

1. Pulmonary contusion

2. Cardiac contusion

3. Aortic injury

4. Diaphragmatic injury

The correct answer is: Cardiac contusion

A sternal fracture often occurs due to direct blunt trauma to the chest, such as from a motor vehicle accident or a fall. Given the location and mechanism of this injury, one potential complication is a cardiac contusion. A cardiac contusion occurs when the heart tissue is bruised, typically from the impact of the fractured sternum or from the force exerted on the thorax. When the sternum fractures, it can directly affect the heart, potentially causing damage to the myocardial tissue or the pericardium. This contusion may not always be readily apparent on initial imaging but can lead to serious complications, including arrhythmias or impaired cardiac function if not recognized and managed appropriately. The other options, while possible complications in trauma cases, are less directly related to sternal fractures. Pulmonary contusions typically relate to lung injuries from blunt chest trauma, aortic injuries are more associated with severe deceleration injuries, and diaphragmatic injuries usually arise from penetrating trauma or significant blunt force impacts that significantly compress the abdomen. Therefore, the mechanism and anatomical considerations surrounding a sternal fracture make a cardiac contusion the most relevant risk.