Median Sternotomy After Sternal Reconstruction With Bilateral Longitudinal Plating in a Patient With Osteoporosis
DOI:
https://doi.org/10.1532/hsf.2783Keywords:
median sternotomy, longitudinal plating, osteoporosisAbstract
In recent decades, new information has arisen regarding sternal healing and extended indications for using rigid plate fixation in patients during cardio-thoracic procedures. Three randomized controlled multicenter clinical trials recently demonstrated positive results after rigid plate fixation, including reduced sternal complications and decreased length of hospital stay. However, redo-sternotomy after sternal reconstruction utilizing rigid fixation has not been previously delineated in surgical literature. This case highlights the technical challenges of performing a median sternotomy for cardiac surgery after sternal reconstruction with bilateral longitudinal plating.
References
Francel TJ, Kouchoukos NT. 2001. A rational approach to wound difficulties after sternotomy: reconstruction and long-term results. Ann Thorac Surg 72:1419-29.
Madjarov JM, Katz MG, Kane PN, Madzharov S, Robicsek F. 2018. Early surgical reconstruction of sternum with longitudinal rigid polymer plating after acute chest trauma. Ann Thorac Cardiovasc Surg
:324-327.
Robicsek F, Daugherty HK, Cook JW. 1977. The prevention and treatment of sternum separation following open-heart surgery. J Thorac Cardiovasc Surg 73:267-8.
Schimmer C, Sommer SP, Bensch M, Bohrer T, Aleksic I, et al. 2008. Sternal closure techniques and postoperative sternal wound complications in elderly patients. Eur J Cardiothorac Surg 34:132-8.
Tam DY, Nedadur R, Yu M, Yanagawa B, Fremes SE, et al. 2018. Rigid plate fixation versus wire cerclage for sternotomy after cardiac surgery: a meta-analysis. Ann Thorac Surg 106:298-304.
Zeitani J, Penta de Peppo A, Moscarelli M, et al. 2006. Influence of sternal size and inadvertent paramedian sternotomy on stability of the closure site: a clinical and mechanical study. J Thorac Cardiovasc Surg 132:38-42.
