Nonunion of the sternum treated with cervical locking plate: A case report

Postoperative transverse sternal nonunion with a chest wall defect managed by a tibial locking plate and a Gore-Tex dual mesh membrane: a case report.

“…Biomechanical advantages of sternal plating were previously shown in a cadaveric study [12]. Other authors also reported good functional outcome of sternal plating, with a high rate of union mainly after the usage of the one or two parallel locking plates [3,[5][6][7]9,13,14]. Locking implants, with screws that are angular stable locked in the plate, in contrast to conventional plating better resist continuous multidirectional forces that act on the construct during breathing.…”

“…Additionally, monocortical locking screws could be used as a safer option to prevent an iatrogenic injury to the retrosternal vital structures. But on the other hand, they provide less purchase than bicortical locking screws, especially in a weaker bone [3,9]. A review of the published literature done by Schulz et al in 2015 showed good results for the most locking plate systems that were used, and a review from Klei et al from 2018 con rmed that plating was the most common type of xation after sternal fractures (83%), with a good consolidation rate and low complications [8,15].…”

“…When the patient is symptomatic, sternal nonunion is an indication for a surgical treatment [2][3][4]. The vast majority of sternal nonunions are longitudinal and result from healing disturbances after a median sternotomy.…”

Postoperative transverse sternal nonunion with a chest wall defect managed by a tibial locking plate and a Gore-Tex dual mesh membrane: a case report

“…Biomechanical advantages of sternal plating were previously shown in a cadaveric study [ 15 ]. Other authors also reported good functional outcomes of sternal plating with a high rate of union, mainly after using one or two parallel locking plates [ 2 , 6 , 8 , 9 , 11 , 16 , 17 ]. In contrast to conventional plating, locking implants with screws locked in the plate (angularly stable fixation) better resist continuous multidirectional forces that act on the construct during breathing.…”

“…Additionally, monocortical locking screws can be a safer option to prevent an iatrogenic injury to the vital retrosternal structures. But on the other hand, they provide less purchase than bicortical locking screws, especially in a weaker bone [ 6 , 11 ]. A review of the published literature done by Schulz et al [ 18 ] showed good results for the most locking plate systems that were used and a review from Klei et al from 2018 confirmed that plating was the most common type of fixation after sternal fractures (83%), with a reasonable consolidation and low complication rate [ 10 , 18 ].…”