HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Steven C. Hendrickson Peter K. Smith Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hendrickson, S. C. Articles by Levin, L. S. Search for Related Content PubMed PubMed Citation Articles by Hendrickson, S. C. Articles by Levin, L. S.

Ann Thorac Surg 1996;62:512-518
© 1996 The Society of Thoracic Surgeons

---

Original Articles: Cardiovascular

Sternal Plating for the Treatment of Sternal Nonunion

Divisions of Cardiothoracic Surgery, Plastic and Maxillofacial Surgery, and Orthopaedic Surgery, Department of Surgery, Duke University Medical Center and Durham Veterans Administration Hospital, Durham, North Carolina

Accepted for publication April 3, 1996.

Background. Sternal nonunion, defined as sternal pain with clicking, instability, or both for more than 6 months in the absence of infection, is an uncommon complication of median sternotomy. Nonunion is frequently complicated by the presence of multiple transverse fractures, which make simple rewiring inadequate.

Methods. Six patients with debilitating pain secondary to sternal nonunion were treated with the technique of sternal plating between 1989 and 1995.

Results. Sternal plating corrected sternal instability and provided excellent pain relief in all 6 patients. All patients reported an improved quality of life and were able to resume recreational activities. Two patients have had plate removal for late bursa formation. Sternal healing was complete in both instances.

Conclusions. Sternal plating, which is based on the tension-band principle, is an effective treatment of sternal nonunion. The technique is applicable to both simple and complex nonunions. The stainless steel plates resist bending stresses, and the cortical bone resists compressive forces. The technique requires minimal dissection of the posterior sternal border, is not circumferential, and provides secure sternal approximation.

This article has been cited by other articles:

				A. Morgan Treatment of Chronic Nonunion of a Sternal Fracture With Bone Morphogenetic Protein Ann. Thorac. Surg., February 1, 2008; 85(2): e12 - e13. [Abstract] [Full Text] [PDF]

				J. Raman, D. Straus, and D. H. Song Rigid Plate Fixation of the Sternum Ann. Thorac. Surg., September 1, 2007; 84(3): 1056 - 1058. [Abstract] [Full Text] [PDF]

				K. Knobloch, S. Wagner, C. Haasper, C. Probst, C. Krettek, D. Otte, and M. Richter Sternal Fractures Occur Most Often in Old Cars to Seat-Belted Drivers Without Any Airbag Often With Concomitant Spinal Injuries: Clinical Findings and Technical Collision Variables Among 42,055 Crash Victims Ann. Thorac. Surg., August 1, 2006; 82(2): 444 - 450. [Abstract] [Full Text] [PDF]

				D. R. Gallo, E. D. Lett, and W. C. Conner Surgical Repair of a Chronic Traumatic Sternal Fracture Ann. Thorac. Surg., February 1, 2006; 81(2): 726 - 728. [Abstract] [Full Text] [PDF]

				S. Pai, N. J. Gunja, E. L. Dupak, N. L. McMahon, T. P. Roth, J. F. Lalikos, R. M. Dunn, N. Francalancia, G. D. Pins, and K. L. Billiar In Vitro Comparison of Wire and Plate Fixation for Midline Sternotomies Ann. Thorac. Surg., September 1, 2005; 80(3): 962 - 968. [Abstract] [Full Text] [PDF]

				J. E. Losanoff Invited commentary Ann. Thorac. Surg., September 1, 2005; 80(3): 968 - 968. [Full Text] [PDF]

				R. Bruhin, U. A. Stock, J.-P. Drucker, T. Azhari, J. Wippermann, J. M. Albes, D. Hintze, S. Eckardt, C. Konke, and T. Wahlers Numerical Simulation Techniques to Study the Structural Response of the Human Chest Following Median Sternotomy Ann. Thorac. Surg., August 1, 2005; 80(2): 623 - 630. [Abstract] [Full Text] [PDF]

				R. Sharma, D. Puri, B. P. Panigrahi, and I. S. Virdi A modified parasternal wire technique for prevention and treatment of sternal dehiscence Ann. Thorac. Surg., January 1, 2004; 77(1): 210 - 213. [Abstract] [Full Text] [PDF]

				D. H. Song, J. P. Agarwal, and V. Jeevanandam Rigid sternal fixation in the cardiac transplant population J. Thorac. Cardiovasc. Surg., September 1, 2003; 126(3): 896 - 897. [Full Text] [PDF]

				U. K. Dasika, D. R. Trumble, and J. A. Magovern Lower sternal reinforcement improves the stability of sternal closure Ann. Thorac. Surg., May 1, 2003; 75(5): 1618 - 1621. [Abstract] [Full Text] [PDF]

				D. R. Trumble, W. E. McGregor, and J. A. Magovern Validation of a bone analog model for studies of sternal closure Ann. Thorac. Surg., September 1, 2002; 74(3): 739 - 744. [Abstract] [Full Text] [PDF]

				K. C. Bertin, R. S. Rice, D. B. Doty, and K. W. Jones Repair of transverse sternal nonunions using metal plates and autogenous bone graft Ann. Thorac. Surg., May 1, 2002; 73(5): 1661 - 1662. [Abstract] [Full Text] [PDF]

				D. J. Cohen and L. V. Griffin A biomechanical comparison of three sternotomy closure techniques Ann. Thorac. Surg., February 1, 2002; 73(2): 563 - 568. [Abstract] [Full Text] [PDF]

				M. M. Demirtas, M. Akcar, and S. Sarikaya Avoidance of sternal nonunion with cyanoacrylate gluing Ann. Thorac. Surg., July 1, 1998; 66(1): 304 - 306. [Full Text] [PDF]

				W. Ozaki, S. R. Buchman, M. D. Iannettoni, and E. P. Frankenburg Biomechanical Study of Sternal Closure Using Rigid Fixation Techniques in Human Cadavers Ann. Thorac. Surg., June 1, 1998; 65(6): 1660 - 1665. [Abstract] [Full Text] [PDF]