The sternum forms the central anterior thorax, articulating with the clavicles at the SC joints and the costal cartilages of ribs 1-7. The manubrium-body junction (sternal angle, angle of Louis) is at the level of the second rib — the primary surface landmark for counting ribs. The xiphoid process is the most inferior and variable component. Median sternotomy for cardiac surgery divides the sternum longitudinally and requires sternal wire fixation for healing.
Sternal wound infection after median sternotomy (post-sternotomy mediastinitis) is a life-threatening complication requiring surgical debridement, vacuum-assisted closure, and pectoral or omental flap reconstruction. Sternal fracture from direct impact (steering wheel in MVA) is associated with cardiac contusion — cardiac monitoring for 24-48 hours is mandatory.
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