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Sternal Nonunion: A Review of Current Treatments and a New Method of Rigid Fixation

Wu, Liza C. MD*; Renucci, John D. MD†; Song, David H. MD, FACS*

Original Article

Sternal nonunion as the result of cardiac intervention or trauma remains a morbid condition with serious sequelae. Patients often report pain with breathing, coughing, and/or movement. The authors present 6 patients that were diagnosed with sterile sternal nonunion after cardiac procedure (4) or trauma (2). The cardiac patients presented 5, 7, 15, and 60 months after their cardiac procedure; the trauma patients presented 8 and 12 months after the accident. Diagnosis was made based on the clinical triad of sternal instability, pain, and absence of infection. Management with open reduction and internal rigid plate fixation with Sternalock plates (W. Lorenz Surgical, Inc., Jacksonville, FL) was performed on all 6 patients. There was no incidence of subsequent infection. Pain completely resolved in all patients. All wounds healed to completion, and bone healing was assessed clinically with the absence of instability and pain and follow-up chest radiographs.

Six patients with sterile sternal nonunion were successfully reconstructed with rigid plate fixation, resulting in bony union and relief of pain in all cases.

From the *Section of Plastic and Reconstructive Surgery, University of Chicago Hospitals, Chicago, IL; and †Plastic Surgery Associates, P.C., Grand Rapids, MI.

Received February 20, 2004 and accepted for publication, after revision, May 17, 2004.

Reprints: David H. Song, MD, FACS, Assistant Professor of Surgery, University of Chicago Hospitals Section of Plastic and Reconstructive Surgery, 5841 S. Maryland Ave, MC 6035, Chicago, IL. E-mail: dsong@surgery.bsd.uchicago.edu

© 2005 Lippincott Williams & Wilkins, Inc.