Our First Experience with Rigid Sternal Fixation


Authors: M. Rezler ;  A. Mokráček ;  D. Čoček ;  M. Forst ;  J. Čanádyová
Authors‘ workplace: Kardiocentrum – kardiochirurgie, Nemocnice České Budějovice, a. s., primář: MUDr. A. Mokráček, CSc.
Published in: Rozhl. Chir., 2007, roč. 86, č. 8, s. 410-414.
Category: Monothematic special - Original

Overview

The authors present their first experience with rigid osteosynthesis of the sternum using the SternaLock® system, used in a 61-year old male patient with a complete sternal dehiscence, diagnosed eight years following his aortocoronary bypass. The authors give a brief overview of the methodology and technique of the system implantation, the discussion deals with pros of the rigid fixation procedures and the commonest risk factors resulting in postoperative sternal instability.

Key words:
sternotomy – dehiscence – rigid osteosynthesis


Sources

1. Julian, O. C., Lopez-Belio, M., Dye, W. A. S., et al. The median sternal incision in intracardiac surgery with extracorporeal circulation: a general evaluation of its use in heart surgery. Surg., 1957; 42: 753–761.

2. Grossi, E. A., Culliford, A. T., Krieger, K. H., et al. A survey of 77 major infectious complications of median sternotomy: a review of 7 949 consecutive operative procedures. Ann. Thorac. Surg., 1985; 40: 214–223.

3. Ottino, G., De Paulis, R., Pansini, S., et al. Major sternal wound infection after open-heart surgery: a multivariate analysis of risk factors in 2 579 consecutive operative procedures. Ann. Thorac. Surg., 1987; 44: 173–179.

4. El Oakley, R. M., Wright, J. E. Postoperative mediastinitis: Classification and management. Ann. Thorac. Surg., 1996; 61: 1030–1036.

5. Wu, L. C., Renucci, J. D., Song, D. H. Rigid – plate fixation for the treatment of sternal nonunion. J. Thorac. Cardiovasc. Surg., 2004; 128: 623–624.

6. Breyer, R. H., Mills, S. A., Hudspeth, A. S., et al. A prospective study of sternal wound complications. Ann. Thorac. Surg., 1984; 37: 412–416.

7. Hendrickson, S. C., Koger, K. E., Morea, C. J., et al. Sternal plating for the treatment of sternal nonunion. Ann. Thorac. Surg., 1996; 62: 512–518.

8. Sharma, R., Puri, D., Panigrahi, B. P., et al. A modified parasternal wire technique for prevention and treatment of sternal dehiscence. Ann. Thorac. Surg., 2004; 77: 210–213.

9. Losanoff, J. E., Jones, J. W., Richman, B. W. Primary closure of median sternotomy: techniques and principles. Cardiovasc. Surg., 2002; 10: 102–110.

10. Randolph, T. J., Vogler, H. Nonunions and delayed unions. J. Foot Surg., 1985; 24: 62–67.

11. Stoney, W. S., Alford, W. C., Burrus G. R., et al. Median sternotomy dehiscence. Ann. Thorac. Surg., 1978; 26: 421–426.

12. Robicsek, F., Daugherty, H. K., Cook, J. W. The prevention and treatment of sternum separation following open-heart surgery. J. Thorac. Cardiovasc. Surg., 1977; 73: 267–268.

13. Wu, L. C., Renucci, J. D., Song, D. H. Sternal nonunion: a review of current treatments and a new method of rigid fixation. Ann. Plast. Surg., 2005; 54: 55–58.

14. Song, D. H., Lohman, R. F., Renucci, J. D., et al. Primary sternal plating in high – risk patients prevents mediastinitis. Europ. J. Cardiothorac. Surg., 2004; 26: 367–372.

15. Ozaki, W., Buchman, S. R., Iannettoni, M. D., et al. Biomechanical study of sternal closure using rigid fixation techniques in human cadavers. Ann. Thorac. Surg., 1998; 65: 1660–1665.

16. Pai, S., Gunja, N. J., Dupak, E. L., et al. In vitro comparison of wire and plate fixation for midline sternotomies. Ann. Thorac. Surg., 2005; 80: 962–968.

17. Cohen, D. J., Griffin, L. V. A biomechanical comparison of three sternotomy closure techniques. Ann. Thorac. Surg., 2002; 73: 563–568.

18. Sargent, L. A., Seyfer, A. E., Hollinger, J., et al. The healing sternum: a comparison of osseous healing with wire versus rigid fixation. Ann. Thorac. Surg., 1991; 52: 490–494.

Labels
Surgery Orthopaedics Trauma surgery
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