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Ann Thorac Surg 2008;86:1384-1385. doi:10.1016/j.athoracsur.2008.03.039
© 2008 The Society of Thoracic Surgeons
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Kimberly L. Gandy
Michael J. Moulton
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How To Do It

Sternal Plating to Prevent Malunion of Transverse Sternotomy in Lung Transplantation

Kimberly L. Gandy, MD, PhD*, Michael J. Moulton, MD

Division of Cardiothoracic Surgery, University Medical Center, Tucson, Arizona

Accepted for publication March 20, 2008.

* Address correspondence to Dr Gandy, Division of Cardiothoracic Surgery, Department of Surgery, Medical College of Wisconsin, 9000 W. Wisconsin Avenue, MS715, Milwaukee, WI 53226 (Email: kgandy{at}mcw.edu).

Sternal malunion can be a significant cause of morbidity in double-lung transplantation when it is performed through a thoracosternotomy or clamshell incision. Some patients experience increased pain with malunion and have delayed or decreased functional recovery. We propose a method of sternal plating to decrease the incidence of sternal malunion encountered with this incision. The transverse sternotomy can be rigidly fixed with two titanium interlocking plates during chest closure, a procedure that offers the potential for timely and consistent union of the sternum. The interlocking plate configuration also affords a unique quality to this closure; a pin securing the two plates can be quickly released allowing expedient access to mediastinal structures if emergent re-entry is necessary.






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