Middle Breastbone
Sports and Automobile Injuries to the Middle Breastbone
The middle breastbone, known as the sternum, is, in humans, a long bone at the center of the chest. It reaches up as far at the collarbone where it connects to them. It is rarely injured because of its location, but when it is, the damage is often life threatening.
To understand why, you have to understand a little bit about both the location and the development of the sternum.
The Middle Breastbone in Human Development
In babies, the sternum is actually three bones that slowly come together as the human being develops. The sternum forms a T shape, with the top of the sternum, the manubrium, connecting it to the clavicles. The middle section, the gladiolus, is a flat bone that connects with the rib cage. It is broken into sections and a depression between the third and fourth sections is often evident.
At the bottom of the sternum is the third bone that makes up the middle breastbone. The xyphoid process as it is called, acts as a reinforcement for the gladiolus, but it only attaches on fully between the teens years and the end of one’s twenties. In small slim children, one can usually see the xyphoid sticking out just below the rib cage.
Sternum Fracture
The most common cause of damage to the sternum is an automobile accident in which the force of the collision impales the driver’s chest against the steering column. Generally speaking, chest trauma cause about 25% of deaths related to trauma. Of this minor percentage of blunt force traumas to the chest, less than one in ten breaks result in a break to the middle breastbone. However, when such a break does occur, medical professionals take note because of the high correlation between breaks to the sternum and pulmonary damage. In most cases of such injury, the individual in question will suffer at least pain during breathing if not more severe breathing problems.
A direct blow to the chest can also cause commotio cordis, which is similar to a heart attack in that it involves a disruption in the normal heart beat function. The condition occurs when a blow to the chest coincides with a particular instant in the heartbeat. The blow works like a defibrillator in reverse, shocking the heart out of its normal rhythm at just the wrong moment. Although this kind of complication sometimes occurs during a car crash, it is much more common in sports—especially as a result of a direct strike to the chest in baseball. The baseball works as a deadly projectile leading to death in two out of three instances.
Typically, these sports related injuries occur to males in their teens (average age being fifteen roughly). The reason for this gender and age cluster seems to involve both the types of sport and the nature of bone development in the chest. First, male sports such as baseball involve more dangerous forces (a hard ball, projected at greater velocities than a soft ball) and with a larger number of male than female participants (more boys are involved in such sports than girls). Second, because the chest bone structure in teens is not fully developed until their twenties in most cases, teens are particularly vulnerable to such injuries. In the cases where individuals survived these injuries, defibrillators were usually the method used to revive them.
The vital importance of the middle breastbone has lead to several safety regulations in both cars and in sports. We need to continue our efforts however, if we want to protect both passengers in automobiles and teen participants in sports. One recommendation might be to require defibrillators to be present at all organized sports activities along with someone certified with their use. Although, such measures may seem extreme for such a rare occurrence, they still might well be worth it if they save a handful of lives each year.