Composite plate and wire fixation for complicated sternal closure

Many techniques have been described to achieve closure of complicated median sternotomy wounds. The standard method of closure uses stainless steel wiring of the sternal halves; however, in complicated sternal closures, sternal cut-through and wire failure can occur. Recent literature advocates the...

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Bibliographic Details
Published inAnnals of plastic surgery Vol. 53; no. 3; p. 217
Main Authors Mitra, Amithabha, Elahi, Mohammed M, Tariq, Gul Bano, Mir, Harris, Powell, Rhoda, Spears, Julia
Format Journal Article
LanguageEnglish
Published United States 01.09.2004
Subjects
Aged
Aged, 80 and over
Bone Plates
Bone Wires
Female
Humans
Male
Middle Aged
Reconstructive Surgical Procedures
Stainless Steel
Sternum - surgery
Titanium
Treatment Outcome
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Summary:Many techniques have been described to achieve closure of complicated median sternotomy wounds. The standard method of closure uses stainless steel wiring of the sternal halves; however, in complicated sternal closures, sternal cut-through and wire failure can occur. Recent literature advocates the use of fixation plates that achieve bony union, with plating across the median sternal osteotomy site as a singular method. We describe a technique of composite closure using titanium fixation plates to buttress the sternum in combination with circumferential stainless steel wires. This composite technique has been used in 6 patients with complicated sternal closures. Successful wound closure without complication was achieved in all cases. The technique and the clinical series with an illustrative example are presented. The use of plate and wire fixation represents an alternate method to conventional techniques to achieve sternal closure, stability, and uncomplicated wound healing in these difficult-to-manage cases.
ISSN:0148-7043
DOI:10.1097/01.sap.0000120316.11969.e0