Faster diagnosis, smarter care? Point of care ultrasound for pediatric sternal fractures secondary to indirect trauma: a case series.

This multisite case series examines the role of point-of-care ultrasound (POCUS) in diagnosing isolated sternal fractures in pediatric patients following indirect trauma. While traditionally linked to high-impact injuries and major trauma, these fractures can also occur in children participating in leisure activities like trampoline jumping. We aim to highlight POCUS as a rapid, radiation-free alternative to traditional imaging. We included pediatric patients presenting with acute chest pain after indirect trauma at three clinical sites in Switzerland. POCUS was performed by trained physicians to detect cortical discontinuity, confirming sternal fractures. Patients were managed conservatively and followed up by phone. Eleven children (median age: 11 years) were diagnosed with isolated sternal fractures, with the majority involving hyperflexion injuries. None had external signs of trauma. POCUS swiftly identified fractures, enabling immediate diagnosis without additional imaging. All patients recovered fully with conservative management, and no repeat visits or complications were reported. POCUS could be an effective, non-invasive tool for diagnosing pediatric sternal fractures following indirect trauma. It may facilitate rapid evaluation, avoid unnecessary imaging, and may streamline management, making it a valuable first-line diagnostic modality in pediatric emergency care.