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

This Article 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 Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Sargent, L. A. Articles by Graeber, G. M. Search for Related Content PubMed PubMed Citation Articles by Sargent, L. A. Articles by Graeber, G. M.

The Annals of Thoracic Surgery, Vol 52, 490-494, Copyright © 1991 by The Society of Thoracic Surgeons

ARTICLES

The healing sternum: a comparison of osseous healing with wire versus rigid fixation

LA Sargent, AE Seyfer, J Hollinger, RM Hinson and GM Graeber
Plastic Surgery Service, Walter Reed Army Medical Center, Washington, DC.

Although median sternotomy is used for most cardiac procedures, postoperative dehiscence remains a serious and persistent problem. This investigation was designed to assess new bone formation and sternal healing across the linear osteotomy of the sternum and to determine if rigid fixation would enhance bony healing and thus decrease unfavorable sequelae. To test this hypothesis, 14 skeletally mature baboons (Papio anubis) underwent standard median sternotomy; seven sternotomies were closed with interrupted 24-gauge cerclage wires, and seven, with thin Vitallium compression miniplates and transverse lag screws. The sterna from each group were harvested en bloc at 4 and 8 weeks, radiographed, processed, and serially sectioned and stained for histomorphometry to assess the quantity of new bone across the linear osteotomy. Clinical stability was superior with the plated and lag screw group at 4 weeks; however, by 8 weeks, no clinical difference between treatments was apparent. Histomorphometric analysis indicated that the linear osteotomy gap treated with plates and screws was less than the gap associated with the wire group. Rigid fixation of the sternum resulted in earlier union with primary osseous healing, suggesting greater inherent stability. these factors may decrease adverse sequelae for this procedure.

This article has been cited by other articles:

				B. Voss, R. Bauernschmitt, A. Will, M. Krane, R. Kross, G. Brockmann, P. Libera, and R. Lange Sternal reconstruction with titanium plates in complicated sternal dehiscence. Eur. J. Cardiothorac. Surg., July 1, 2008; 34(1): 139 - 145. [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]

				B. Voss, R. Bauernschmitt, G. Brockmann, and R. Lange Osteosynthetic thoracic stabilization after complete resection of the sternum Eur. J. Cardiothorac. Surg., August 1, 2007; 32(2): 391 - 393. [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]

				J. E. Losanoff, A. D. Collier, C. C. Wagner-Mann, B. W. Richman, H. Huff, F.-h. Hsieh, A. Diaz-Arias, and J. W. Jones Biomechanical comparison of median sternotomy closures Ann. Thorac. Surg., January 1, 2004; 77(1): 203 - 209. [Abstract] [Full Text] [PDF]

				T. Hasegawa, M. Yamaguchi, Y. Ohshima, N. Yoshimura, S. Oka, and Y. Ootaki Simultaneous repair of pectus excavatum and congenital heart disease over the past 30 years Eur. J. Cardiothorac. Surg., December 1, 2002; 22(6): 874 - 878. [Abstract] [Full Text] [PDF]

				J. E. Losanoff, B. W. Richman, and J. W. Jones Disruption and infection of median sternotomy: a comprehensive review Eur. J. Cardiothorac. Surg., May 1, 2002; 21(5): 831 - 839. [Abstract] [Full Text] [PDF]

				A. Erdogan, A. Ayten, N. Oz, and A. Demircan Early and Long-Term Results of Surgical Repair of Pectus Excavatum Asian Cardiovasc Thorac Ann, March 1, 2002; 10(1): 39 - 42. [Abstract] [Full Text] [PDF]

				A.R. Casha, M. Gauci, L. Yang, M. Saleh, P.H. Kay, and G.J. Cooper Fatigue testing median sternotomy closures Eur. J. Cardiothorac. Surg., March 1, 2001; 19(3): 249 - 253. [Abstract] [Full Text] [PDF]

				A. R. Casha, M. Gauci, L. Yang, and G. J. Cooper New improved sternal bands - a biomechanical analysis Eur. J. Cardiothorac. Surg., October 1, 2000; 18(4): 502 - 502. [Full Text] [PDF]

				A. R. Casha, S. S. Ashraf, P. H. Kay, and G. J. Cooper Routine sternal closure using interlocking multitwisted wires Eur. J. Cardiothorac. Surg., September 1, 1999; 16(3): 353 - 355. [Abstract] [Full Text] [PDF]

				J. Kowalewski and M. Brocki Long-term observation in 68 patients operated on for pectus excavatum: surgical repair of funnel chest Ann. Thorac. Surg., March 1, 1999; 67(3): 821 - 824. [Abstract] [Full Text] [PDF]

				A.R. Casha, L. Yang, P.H. Kay, M. Saleh, and G.J. Cooper A biomechanical study of median sternotomy closure techniques Eur. J. Cardiothorac. Surg., March 1, 1999; 15(3): 365 - 369. [Abstract] [Full Text] [PDF]

				T. Matsui, M. Kitano, T. Nakamura, Y. Shimizu, S-H. Hyon, and Y. Ikada Bioabsorbable struts made from poly-L-lactide and their application for treatment of chest deformity J. Thorac. Cardiovasc. Surg., July 1, 1994; 108(1): 162 - 168. [Abstract] [Full Text]