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Ann Thorac Surg 1991;51:56-59
© 1991 The Society of Thoracic Surgeons

Articles

Delayed chest wall pain due to sternal wire sutures

Charles E. Eastridge, MD*, Saade S. Mahfood, MD, LCdr, William A. Walker, MD, USNR, F.Hammond Cole, Jr, MD

Division of Thoracic Surgery, Veterans Administration Medical Center, and Department of Surgery, University of Tennessee, Memphis, Tennessee USA

Accepted for publication August 29, 1990.

* Address reprint requests to Dr Eastridge, Veterans Administration Medical Center, 1030 Jefferson Ave, Memphis, TN 38104.

This report describes 18 patients with disabling chest wall pain due to one or more sternal wire sutures. The pain occurred from 2 to 84 months after a median sternotomy. The pain was described either as sharp and stabbing or as a deep-seated ache. The involved wires had an exaggerated fibrous tissue reaction surrounding the twisted portion. The adjacent noninvolved wires had minimal reaction. In the last 7 patients, serial sections of the fibrous tissue revealed entrapment of one or more sensory nerve fibers. In 6 of the 7 electrical potentials were measured and found to be elevated, indicating wire damage during twisting. Ferroxyl tests confirmed the collection of iron ions at this anodic point as a result of corrosion. Removal of the involved wires and the fibrous tissue surrounding this anodic point relieved the symptoms of pain and tenderness resulting from entrapped sensory nerves.




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