Abstract
Objectives: Titanium plate osteosynthesis (Synthes) is an alternative option for sternal closure.
The indications and time point of application are still debated. This study investigated
the application and feasibility of this technique after median sternotomy. Methods: Forty-one patients (29 M/12F, mean age 63 ± 17 years) received the plate system for
complicated sternal conditions. Indications, intraoperative course and postoperative
follow-up were assessed. Results: Sternal deformity was present in 5 % (2/41), sternal fractures in 17 % (7/41), bone
defect in 12 % (5/41), wire loosening in 39 % (16/41) and pseudoarthrosis in 27 %
(11/41). 54 % (22/41) of patients showed concomitant sternal infection. Two intraoperative
complications were noted: mammary artery injury (1 patient), pleural injury (1 patient).
At discharge the patients reported no pain (90 %, 37/41) or only occasional discomfort
(10 %, 4/41). Postoperative complications were subcutaneous hematoma in 12 % (5/41),
seroma in 12 % (5/41) and sternal reinfection in 7 % (3/41). 12 % (5/41) showed occasional
discomfort and 7 % (3/41) had persistent pain leading to plate removal. Conclusion: The Titanium Sternal Fixation System is comfortable and easy to use. It can be used
to treat a wide spectrum of indications, especially for pseudoarthrosis, an entity
which has not yet received sufficient attention.
Key words
sternal complications - infection - plate osteosynthesis
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Dr. Andre Plass, MD
Clinic for Cardiovascular Surgery
University Hospital Zurich
Raemistr. 100
8032 Zurich
Switzerland
Telefon: +41 4 42 55 11 11
Fax: +41 4 42 55 11 11
eMail: andre.plass@usz.ch