A high-energy mechanism — road traffic accident, significant fall, sports impact.
Sternal (breastbone) fracturesUsually the work of a seatbelt, airbag or fall — and painful with every breath, cough and change of position. Most sternal fractures heal well with the right support. The two jobs that must not be skipped: excluding injury to what lies behind the sternum, and not accepting a painful non-healing fracture as permanent.
Page last updated 5 August 2026
A high-energy mechanism — road traffic accident, significant fall, sports impact.
Severe pain limiting breathing, coughing or sleep despite analgesia.
A clicking, grinding or moving sensation in the breastbone.
Visible deformity or a step you can feel.
Pain not clearly improving by 6–8 weeks — or any pain beyond 12.
Rib fractures alongside — combined injuries change the plan.
Initial assessment covers the injury behind the bone as well as the bone itself: an ECG and blood tests where the mechanism warrants it, and CT imaging to define the fracture pattern and check for associated rib, spine or internal injuries. With that done, most patients can be managed confidently without surgery.
Regular analgesia (nerve blocks where pain is severe), hourly breathing exercises, pillow-brace coughing, sleep positioning, and a graduated return to activity — reviewed so nothing drifts.
For markedly displaced or unstable fractures, overlap deformity, and painful nonunion: low-profile titanium plates restore rigidity and alignment. Patients with months of grinding, unstable pain typically notice the difference as soon as they are moving again.
A short hospital stay, early walking, protected pushing and lifting for the first weeks, and physiotherapy-guided return to full activity — with Mr Scarci reviewing you personally throughout.
“ ★★★★★“The seatbelt bruise faded but the pain in my breastbone didn’t. A&E said it would settle on its own — six weeks later I still couldn’t lie flat or reverse the car. Mr Scarci reviewed my CT before I even arrived, set out a proper plan, and checked at eight weeks that it had actually healed. Night and day from being left to get on with it.”
“ ★★★★★“Ten months after my accident my sternum still clicked every time I pushed a door. Everyone said give it time. A CT showed the fracture had never joined. Mr Scarci fixed it with titanium plates and the clicking — and the pain — stopped. I only wish someone had told me nonunion was a thing at month three, not month ten.”
“ ★★★★★“My mother fractured her sternum in a low-speed collision at 78. The hospital sent her home the same day with paracetamol. Mr Scarci saw her within 48 hours, checked her spine as well, and managed her pain so she could breathe and sleep properly. The follow-up was meticulous.”
MD(Hons) · FRCS(Eng) · FCCP · FACS · FEBTS · Consultant Thoracic Surgeon, Imperial College Healthcare NHS Trust
The sternum belongs to thoracic surgery — it is the bone thoracic and cardiac surgeons open, close, wire and plate as part of their daily work. That is the depth of familiarity Mr Scarci brings to the fractured breastbone: the judgement to know which fractures will heal with structured conservative care, the discipline to verify that they actually have, and the surgical technique to fix the ones that have not.
He performs every sternal fixation himself, reviews every scan personally before your consultation, and follows your recovery through to confirmed union — the same surgeon from first appointment to discharge.
Five London clinic locations. No GP referral required. Bring any existing scans — they are reviewed before you arrive.
St John’s Wood, NW8 9LE
11:00am–1:00pm Monday PMMarylebone, W1G 6BW
5:30–7:30pm Tuesday PMBorehamwood, WD6 3BS
5:30–7:30pm Wednesday AMHammersmith, W12 0HS
9:00–11:00am Thursday AMSouth Kensington, SW5 0TU
9:30am–12:30pmNot in London? Remote video consultations are available for review of existing imaging before you travel.
Most sternal fractures heal in 6–12 weeks with good pain control, breathing exercises and a graduated return to activity. Pain should improve steadily; discomfort with coughing and certain movements can linger towards the end of that window. Pain that plateaus or worsens — or any clicking or grinding sensation — warrants review before the 12-week mark.
The sternum sits directly over the heart, so significant sternal trauma — especially from a steering wheel, seatbelt or high-speed impact — should include cardiac assessment at the time of injury: an ECG, blood tests and imaging as indicated. Once that early screen is clear, late cardiac complications are uncommon, and treatment focuses on the bone and your comfort.
Rarely — most heal without it. Titanium plate fixation is considered for markedly displaced or unstable fractures, fractures with overlapping ends, painful nonunion (no healing by around 8–12 weeks), and persistent instability with clicking or movement. When those criteria are met, fixation reliably restores stability and typically transforms the pain.
Propped up on pillows or in a recliner for the first couple of weeks, hugging a pillow when you cough or sneeze, and avoiding pushing up through your arms — roll onto your side and push up sideways instead. Keep walking daily and do regular deep-breathing exercises: protecting your lungs matters just as much as protecting the bone.
Sternal and rib fractures from road traffic accidents are core work for this practice. Assessment and treatment can proceed immediately — funded by your insurer, self-pay, or in many cases recovered through your personal injury claim, for which the practice provides full clinical documentation. Mr Scarci also prepares medicolegal reports in chest trauma, so records are kept to the standard solicitors and courts require.
Sudden severe breathlessness at rest, coughing up blood, blue lips or fingertips, crushing central chest pain, fainting, or a section of the chest visibly moving the wrong way with breathing: these need an emergency ambulance, not an outpatient appointment.
Whether it happened last week or refuses to heal months later — one consultation establishes exactly where you stand and what, if anything, needs doing.