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Ann Thorac Surg 1998;65:1660-1665
© 1998 The Society of Thoracic Surgeons

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Original articles: general thoracic

Biomechanical Study of Sternal Closure Using Rigid Fixation Techniques in Human Cadavers

^a Section of Plastic and Reconstructive Surgery, University of Michigan Medical Center, Ann Arbor, Michigan, USA
^b Section of Cardiothoracic Surgery, Department of Surgery, University of Michigan Medical Center, Ann Arbor, Michigan, USA
^c Orthopedic Research Laboratory, University of Michigan Medical Center, Ann Arbor, Michigan, USA

Accepted for publication January 30, 1998.

Address reprint requests to Dr Buchman, Section of Plastic and Reconstructive Surgery, University of Michigan Medical Center, F7859 Mott Hospital, 1500 E Medical Center Dr, Ann Arbor, MI 48109-8063

Background. We believe rigid plate fixation may be superior to wire fixation in sternal closure, as rigid fixation used in the craniofacial skeleton has shown greater stability, lower postoperative pain, and accelerated bone healing. We hypothesize that sterna fixed with titanium plates are more stable mechanically than sterna fixed with wires.

Methods. The sterna from human cadavers were used in this two-phased study. Phase I compared wires to four-hole titanium straight plates. Phase II compared wires to four-hole titanium custom H plates. The sterna were tested biomechanically using all fixation methods.

Results. Phase I showed no statistically significant difference in the stiffness or lateral displacement between the wired and straight plated sterna. Phase II showed a statistically significant greater stiffness (p < 0.05) and less lateral displacement (p < 0.05) in the custom plated sterna over the wired sterna.

Conclusions. Our results showed that custom titanium H plates were superior to wire fixation. Furthermore, our results established the importance of plate configuration in sternal fixation. Our study may have beneficial clinical implications, as decreased motion at the sternotomy site could mean less postoperative pain, a decreased incidence of infection, and accelerated bone healing.

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