Sternal Fracture Fixation: A Path to Recovery

From Trauma to Triumph: How Sternal Fixation Can Ease Pain and Restore Movement

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Soraya Malik in Health & Wellness November 2026 • 4 min read.

"Discover how surgical sternal fixation is revolutionizing recovery for patients with traumatic sternal fractures, offering a path to reduced pain and improved upper extremity function."


Sternal fractures, often resulting from traumatic injuries, present a significant challenge for patients. The intense pain and restricted movement, particularly in the upper extremities, can severely impact daily life and hinder recovery.

Traditionally, treatment has focused on pain management, often delaying a return to normal activities. However, a promising surgical approach known as sternal fixation is gaining traction, offering a potential solution to alleviate pain and improve upper extremity range of motion. This approach aims to stabilize the fractured sternum, promoting faster healing and improved function.

This article explores the benefits of sternal fixation for traumatic sternal fractures, drawing on recent research to understand how this procedure can revolutionize patient recovery. We'll delve into the outcomes, advantages, and what the future holds for this innovative treatment.

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Prevalence and Reported Outcomes

A 2018 review of 16 studies covering 191 patients reported sternal healing in all patients, pain relief in 98%, and treatment complications in 2%. A 2025 report states that sternal fractures occur in about 3.9% of severely injured patients, while rib fractures affect almost half of that population. The 2024 quality-of-life study examined patients treated with surgical fixation or nonoperative management at a Level 1 academic trauma center between January 2016 and July 2021.

Conservative Care and Surgical Indications

Pain-management recommendations for sternal fractures are commonly extrapolated from regimens used for postoperative, thoracic, and musculoskeletal injuries. Most sternal fractures can be managed nonoperatively, but surgical fixation may be considered for displaced fractures that cannot be reduced by closed techniques, symptomatic nonunion, instability, or pain that limits respiratory function. An evidence-based guideline reports that 60% to 80% of sternal fractures are caused by motor vehicle accidents, with falls and direct trauma also contributing. For sternal closure after median sternotomy, steel wire remains widely used because it is cost-effective and has low rates of sternal wound complications, although complications are more frequent in some patients with chronic disease, steroid treatment, thoracic radiation, or advanced age.

An Evolving Treatment Tradition

The treatment of sternal fractures has generally evolved from a predominantly conservative approach toward more selective use of stabilization. This shift appears to reflect greater attention to displacement, instability, nonunion, and pain-related respiratory limitation. Because no source material was provided for a detailed historical chronology, specific milestones and dates cannot be established here.

Sternal Fixation: A New Approach to Fracture Management

Sternal Fracture Fixation: A Path to Recovery

A study presented at a recent Scientific Forum, led by Zachary M. Bauman and colleagues at the University of Nebraska Medical Center, investigated the efficacy of surgical sternal fixation. Their research involved a retrospective review of patients who underwent sternal fixation following traumatic sternal fractures.

The findings revealed significant improvements in patient outcomes. Here's a breakdown of the key benefits:

  • Reduced Pain: Patients experienced a notable decrease in pain levels following sternal fixation.
  • Decreased Narcotic Requirements: The need for pain medications, particularly narcotics, was significantly reduced.
  • Improved Upper Extremity Range of Motion: Patients regained better mobility and function in their upper extremities.
  • Faster Recovery: Sternal fixation facilitated a quicker return to daily activities and overall improved recovery.
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Long-Term Outcomes Under Study

Recent research describes sternal fixation as a viable treatment option while noting that literature on its long-term benefits remains limited. A separate outcomes study is examining whether fixation improves pain and respiratory function and decreases opioid use. Together, these studies indicate that current research is focused not only on fracture healing but also on quality of life, breathing, pain, and medication needs.

Limits of the Evidence

Sternal fixation is not necessarily appropriate for every fracture, since many injuries can be managed without surgery. The available evidence may be limited by variation in injury severity, treatment selection, and outcome measurement. Patients and clinicians therefore must weigh potential benefits against the uncertainties and burdens of an operation.

Fixation Versus Nonoperative Management

Comparative research has evaluated trauma patients undergoing surgical sternal fixation against patients receiving nonoperative management for traumatic sternal fractures. One report concludes that surgical fixation offers a clear mortality advantage and may improve pain outcomes when fractures involve instability or displacement. The same report states that conservative management remains effective for less severe injuries, supporting a severity-based approach rather than a universal preference for surgery.

The study also reported no postoperative complications among the patients, with a majority being discharged home or to acute rehabilitation, highlighting the safety and effectiveness of the procedure.

Looking Ahead: The Future of Sternal Fracture Treatment

Sternal fixation represents a significant advancement in the treatment of traumatic sternal fractures. By providing stability, reducing pain, and improving function, this surgical approach offers patients a pathway to faster and more complete recovery.

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A Selective Path to Recovery

Taken together, the available material supports viewing sternal fixation as a selective treatment rather than a routine response to every fracture. Its potential relevance is greatest when displacement, instability, persistent symptoms, or impaired breathing make conservative care less satisfactory. Decisions should remain individualized because the evidence base includes limited long-term literature and variation in injury severity.

Expanding Market and Access

Market reports describe significant growth avenues for the global Medical Sternal Fixation System Market, citing regional diversification, favorable policies, and expanding end-use applications. Another report attributes steady growth in the Sternal Fixation System Market to internal innovation, increasing consumer awareness, lifestyle changes, improved accessibility, and broader affordability. These projections suggest that future development may involve both device innovation and wider access, although the supplied sources do not provide specific market-size figures.

Care Beyond the Procedure

Sternal-fracture care occurs within a broader trauma system in which injury severity, associated injuries, and available expertise can influence management. The choice between fixation and nonoperative treatment must account for both the fracture and the patient's overall condition. Clearer comparative evidence may help standardize decisions across different clinical settings.

Pain, Breathing, and Daily Life

For patients, the practical consequences of a sternal fracture can include pain, restricted movement, and difficulty with breathing-related activities. Treatment decisions therefore extend beyond radiographic healing to questions about comfort, respiratory function, opioid use, and quality of life. The potential value of fixation lies in whether it meaningfully improves those lived outcomes for appropriately selected patients.

While the initial results are promising, researchers emphasize the need for further prospective studies to solidify these findings and explore the long-term benefits of sternal fixation. These studies will help refine the procedure, identify ideal candidates, and optimize post-operative care.

For individuals suffering from traumatic sternal fractures, sternal fixation offers hope for a return to a more active and pain-free life. Discussing this option with a qualified medical professional is a crucial step in exploring the best course of treatment and recovery.

Pain and medication changes after fixation

  • 3.54Average pain fell from 7.08 before surgery to 3.54 afterward, a decrease of 3.54 points; the reported average improvement was 3.5 points.[1]
  • 7.59 MMEAverage narcotic requirements decreased from 71.78 to 64.19 MME, a reduction of 7.59 MME.[1]

What the pain and medication results show

The pain result compares patients’ scores before and after fixation, so it documents improvement within the treated group rather than establishing how their pain would have changed without surgery.[1]

Reduced medication use accompanied the pain improvement, but the reported change does not by itself establish that fixation caused the reduction.[1]

How fixation compares with other evidence

A separate comparison found better quality of life in the fixation cohort than in the nonoperative cohort across all reported categories except anxiety and depression; its conclusion also describes better overall health scores. This offers a comparison with nonoperative care, unlike the before-and-after pain and medication measures.[2]

The pain-and-movement findings come from a retrospective review of patients treated by a single trauma surgeon at a Level I trauma center. That design describes outcomes in this treated group, not a randomized comparison.[1]

A review of fixation literature describes the supporting studies as generally poor in quality and mostly small, single-surgeon series; another account notes that outcomes are difficult to define because much of the literature consists of case reports and small retrospective series.[3]

What remains uncertain about fixation

  • How consistently do quality-of-life differences appear across categories, given the exception for anxiety and depression?[2]
  • How well do results from small, single-surgeon series and case reports represent outcomes beyond those reported settings?[3]

Sources

  1. Sternal fixation for isolated traumatic sternal fractures improves pain and upper extremity range of motion. (pubmed.ncbi.nlm.nih.gov)
  2. Sternal fixation for traumatic sternal fractures demonstrates better long-term quality of life outcomes than nonoperative management: A survey analysis. (onlinelibrary.wiley.com)
  3. Traumatic sternal fractures: a narrative review (pmc.ncbi.nlm.nih.gov)

About this Article -

Written with AI assistance from published research, and reviewed by the Mystum team. See our About page for more information.

Everything You Need To Know

1

What is sternal fixation and when is it typically used?

Sternal fixation is a surgical procedure used to stabilize fractures of the sternum, or breastbone. It aims to reduce pain, improve upper extremity range of motion, and promote faster healing following traumatic injuries that cause these fractures. The procedure involves surgically fixing the fractured sternum to provide stability.

2

What key benefits were observed in the study on sternal fixation performed at the University of Nebraska Medical Center?

The study led by Zachary M. Bauman and colleagues at the University of Nebraska Medical Center, demonstrated that sternal fixation leads to reduced pain, decreased narcotic requirements, improved upper extremity range of motion, and a faster recovery for patients with traumatic sternal fractures. Postoperative complications were absent in the studied patients.

3

How does sternal fixation differ from traditional treatments for sternal fractures?

Traditional treatments for sternal fractures primarily focus on pain management, often with narcotics, and can delay the return to normal activities. In contrast, sternal fixation addresses the root cause of the problem by stabilizing the fracture. This can lead to reduced pain and faster recovery compared to non-surgical approaches. While pain management remains important, sternal fixation offers a proactive surgical solution for improved outcomes.

4

Why is improved upper extremity range of motion so important following sternal fixation?

Improved upper extremity range of motion after sternal fixation is crucial because sternal fractures often restrict movement and function in the arms and shoulders. By stabilizing the sternum, sternal fixation allows patients to regain better mobility and function, enabling them to perform daily activities more easily and improve their overall quality of life. This is likely achieved by reducing pain and restoring the structural integrity of the chest.

5

What are the limitations of the research about sternal fixation, and what further investigations might be helpful?

While the study highlights the positive outcomes of sternal fixation, it's important to consider potential limitations. The research was a retrospective review, and further prospective studies with larger patient populations may be needed to confirm these findings and identify specific patient populations who benefit most from this procedure. The study did not specifically address the long-term outcomes or the cost-effectiveness of sternal fixation compared to traditional treatment methods.

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