Rigid Fixation of the Sternum Using a New Coupled Titanium Transverse Plate Fixation System

In Brief Restoration of sternal integrity after median sternotomy for cardiac interventions better ensures optimal postoperative pulmonary function and minimizes overall morbidity. Sternal dehiscence or nonunion mitigates against such a successful outcome. Under such circumstances, if enough viable and uninfected sternum remains, an anatomic reduction should be attempted. Rewiring usually proves unsuccessful, and rigid plate fixation is more rewarding. A new titanium sternal fixation system that permits transverse orientation of plates has been used in 4 patients who had sterile complete or imminent sternal dehiscence to allow eventual sternal union. The specific advantage of this new system is the presence of a releasing pin in the center of coupled plates to allow rapid chest reentry if required without the specific need for cumbersome plate removal. One patient had delayed removal of an infected plate after sternal union was achieved. Four patients underwent rigid sternal fixation successfully using a titanium plating system with a central releasing pin that permits rapid reopening. One patient underwent delayed plate removal for infection after bony union was achieved.