In Vitro Comparison of Wire and Plate Fixation for Midline Sternotomies

Pai, Shruti; Gunja, Najmuddin J.; Dupak, Erin L.; McMahon, Nicole L.; Roth, Timothy P.; Lalikos, Janice F.; Dunn, Raymond M.; Francalancia, Nicola A.; Pins, George D.; Billiar, Kristen L.

doi:10.1016/j.athoracsur.2005.03.089

Cited by 72 publications

(61 citation statements)

References 23 publications

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“…However, so far there are no randomized clinical trials supporting this opinion. Recent in vitro or animal studies comparing the stability of rigid plate fixation vs wire fixation, proved the significant superiority of rigid plates [14,15]. Despite these findings, until now the clinical use of plates in heart surgery is rare and the most effective placement of the plates has not been defined.…”

Section: Discussionmentioning

confidence: 98%

Sternal reconstruction with titanium plates in complicated sternal dehiscence

Voß

Bauernschmitt

Will

et al. 2008

European Journal of Cardio-Thoracic Surgery

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Section: Discussionmentioning

confidence: 98%

Sternal reconstruction with titanium plates in complicated sternal dehiscence

Voß

Bauernschmitt

Will

et al. 2008

European Journal of Cardio-Thoracic Surgery

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“…21 We recently demonstrated in vitro that three plates spaced evenly along the sternum are sufficient to secure the sternum more effectively than standard wire fixation. 18 However, we also observed relatively large distractions in the lower sternum (xiphoid region) with this simple plate configuration. Motion in this clinically susceptible region indicates that a more stable plating configuration may be beneficial, yet no studies have been conducted to determine optimal placement of plates.…”

Section: Introductionmentioning

confidence: 50%

“…We recently demonstrated that at low lateral forces (<180 N), this configuration provides more stability than standard wire fixation. 18 The second configuration is a variation of 3X whereby one of the three plates is moved as far down the xiphoid as possible without entering the cartilaginous region (3XO). As high distractions at the xiphoid are a clinical concern, placing a plate in this region was considered a logical way of reducing the observed distractions.…”

Section: Choice Of Plating Configurationsmentioning

confidence: 99%

“…18 Briefly, sternum-shaped polyurethane bone models (Model 1025-2, 20 pcf (0.32 g/cm 3 density), Sawbones, Pacific Research Laboratories, Vashon, WA) were bisected using a bone saw and plates were screwed in place using a template to assure reproducible placement. Each of the five configurations was tested on three separate model sterna (n = 3) using our custom fixture (Fig.…”

Section: Experimental Testing Systemmentioning

confidence: 99%

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A Mechanical Study of Rigid Plate Configurations for Sternal Fixation

et al. 2007

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Abstract-Rigid metal plates are a promising alternative to wires for reapproximating the sternum after open-heart surgery due to their potential ability to reduce motion at the wound site and thereby reduce the likelihood of postoperative healing complications. Despite initial clinical success, the use of plates has been limited, in part, by insufficient knowledge about their most effective placement. This study compares the ability of five plate configurations to provide stable closure by limiting sternal separation. Commercially available x-shaped and box-shaped plates were used and combinations of parameters (plate type, location, and number of plates) were investigated in vitro. Lateral distraction tests using controlled, uniform loading were conducted on 15 synthetic sterna and the distractions between separated sternum halves were measured at seven locations. Distractions at the xiphoid, a critical region clinically, varied widely from 0.03 ± 0.53 mm to 4.24 ± 1.26 mm depending on all three plate parameters. Of the configurations tested, three xshaped plates and one box-shaped plate resisted sternal separation most effectively. These results provide the first comparison of plate configurations for stabilizing a sternotomy. However, basic mechanical analyses indicate that sternal loading in vivo is non-uniform; future studies will need to accurately quantify in vivo loading to improve in vitro test methods.

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“…3 Many authors proposed this technique for sternal reconstruction after complicated median sternotomy. 4,5 For traumatic manubriosternal dislocation, the rigid plate osteosynthesis allows a reduced rate of iatrogenic complications and shortened hospitalization because it is an easy method to perform and the immediate clinical improvement.…”

Section: Discussionmentioning

confidence: 99%

Use of demineralized bone matrix and plate for sternal stabilization after traumatic dislocation

Divisi

Crisci

2011

Gen Thorac Cardiovasc Surg

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Traumatic sternal segments dislocation is a rare pathology that is on the increase because of road accidents. Ideal treatment is controversial as it is a benign non-life-threatening lesion. The few cases reported in the literature do not shed light on any preferred procedure. In the present study, three patients were treated by surgical steel monofilament and eight by titanium screws and plates and demineralized bone matrix. The reduced hospitalization, rapid functional recovery, and excellent aesthetic results of the titanium patients make use of the surgical approach inevitable.

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In Vitro Comparison of Wire and Plate Fixation for Midline Sternotomies

Cited by 72 publications

References 23 publications

Sternal reconstruction with titanium plates in complicated sternal dehiscence

Sternal reconstruction with titanium plates in complicated sternal dehiscence

A Mechanical Study of Rigid Plate Configurations for Sternal Fixation

Use of demineralized bone matrix and plate for sternal stabilization after traumatic dislocation

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