Skip to main content
Top
Published in: General Thoracic and Cardiovascular Surgery 2/2023

16-08-2022 | Sternotomy | Original Article

Mechanical simulation study of reapproximated sternum rigidity comparing sternal fixation devices

Authors: Eiki Nagaoka, Hirokuni Arai

Published in: General Thoracic and Cardiovascular Surgery | Issue 2/2023

Login to get access

Abstract

Background

A reliable sternal fixation is one of the most basic parts of cardiac surgery requiring sternotomy for preventing wound complications and promoting early recovery. Although various products have been released to the markets, the characteristics of each device are still unclear.

Methods

A simulation study was conducted to compare the properties of two sternal fixation device: a commonly used monofilament stainless-steel wire and a newly designed cable comprised of several titanium alloys strands. Sternum models made of monomer casting nylon were tied with each material and displaced in longitudinal, antero-posterior, and horizontal directions. Resistance against each directional external force was measured and compared.

Results

The titanium cable showed a higher resistance to every directional displacement since slight deviations and a twofold higher maximum strength than the stainless wire.

Conclusion

An in vitro simulation study revealed the titanium cable system provide stronger sternum fixation than stainless-steel wire
Appendix
Available only for authorised users
Literature
1.
go back to reference Schimmer C, Reents W, Berneder S, Eigel P, Sezer O, Scheld H, Sahraoui K, Gansera B, Deppert O, Rubio A, Feyrer R, Sauer C, Elert O, Leyh R. Prevention of sternal dehiscence and infection in high-risk patients: a prospective randomized multicenter trial. Ann Thorac Surg. 2008;86(6):1897–904.CrossRef Schimmer C, Reents W, Berneder S, Eigel P, Sezer O, Scheld H, Sahraoui K, Gansera B, Deppert O, Rubio A, Feyrer R, Sauer C, Elert O, Leyh R. Prevention of sternal dehiscence and infection in high-risk patients: a prospective randomized multicenter trial. Ann Thorac Surg. 2008;86(6):1897–904.CrossRef
2.
go back to reference Ando M. Effect of internal fixation of the sternum using bioabsorbable pins in small children. J Card Surg. 2019;34(10):983–7.CrossRef Ando M. Effect of internal fixation of the sternum using bioabsorbable pins in small children. J Card Surg. 2019;34(10):983–7.CrossRef
3.
go back to reference Kuroki H, Arai H, Srisont S, Oi K, Tomita M, Mizuno T. Corrugated sheet of unsintered hydroxyapatite poly-l-lactide for sternal fixation: a preclinical study. Ann Thorac Cardiovasc Surg. 2020;26(1):40–6.CrossRef Kuroki H, Arai H, Srisont S, Oi K, Tomita M, Mizuno T. Corrugated sheet of unsintered hydroxyapatite poly-l-lactide for sternal fixation: a preclinical study. Ann Thorac Cardiovasc Surg. 2020;26(1):40–6.CrossRef
4.
go back to reference Tam DY, Nedadur R, Yu M, Yanagawa B, Fremes SE, Friedrich JO. Rigid plate fixation versus wire cerclage for sternotomy after cardiac surgery: a meta-analysis. Ann Thorac Surg. 2018;106(1):298–304.CrossRef Tam DY, Nedadur R, Yu M, Yanagawa B, Fremes SE, Friedrich JO. Rigid plate fixation versus wire cerclage for sternotomy after cardiac surgery: a meta-analysis. Ann Thorac Surg. 2018;106(1):298–304.CrossRef
5.
go back to reference McGregor WE, Trumble DR, Magovern JA. Mechanical analysis of midline sternotomy wound closure. J Thorac Cardiovasc Surg. 1999;117(6):1144–50.CrossRef McGregor WE, Trumble DR, Magovern JA. Mechanical analysis of midline sternotomy wound closure. J Thorac Cardiovasc Surg. 1999;117(6):1144–50.CrossRef
6.
go back to reference Bennett-Guerrero E, Phillips-Bute B, Waweru PM, Gaca JG, Spann JC, Milano CA. Pilot study of sternal plating for primary closure of the sternum in cardiac surgical patients. Innovations. 2011;6(6):382–8.CrossRef Bennett-Guerrero E, Phillips-Bute B, Waweru PM, Gaca JG, Spann JC, Milano CA. Pilot study of sternal plating for primary closure of the sternum in cardiac surgical patients. Innovations. 2011;6(6):382–8.CrossRef
7.
go back to reference Raman J, Lehmann S, Zehr K, De Guzman BJ, Aklog L, Garrett HE, MacMahon H, Hatcher BM, Wong MS. Sternal closure with rigid plate fixation versus wire closure: a randomized controlled multicenter trial. Ann Thorac Surg. 2012;94(6):1854–61.CrossRef Raman J, Lehmann S, Zehr K, De Guzman BJ, Aklog L, Garrett HE, MacMahon H, Hatcher BM, Wong MS. Sternal closure with rigid plate fixation versus wire closure: a randomized controlled multicenter trial. Ann Thorac Surg. 2012;94(6):1854–61.CrossRef
8.
go back to reference Allen KB, Thourani VH, Naka Y, Grubb KJ, Grehan J, Patel N, Guy TS, Landolfo K, Gerdisch M, Bonnell M, Cohen DJ. Randomized, multicenter trial comparing sternotomy closure with rigid plate fixation to wire cerclage. J Thorac Cardiovasc Surg. 2017;153(4):888-96.e1.CrossRef Allen KB, Thourani VH, Naka Y, Grubb KJ, Grehan J, Patel N, Guy TS, Landolfo K, Gerdisch M, Bonnell M, Cohen DJ. Randomized, multicenter trial comparing sternotomy closure with rigid plate fixation to wire cerclage. J Thorac Cardiovasc Surg. 2017;153(4):888-96.e1.CrossRef
Metadata
Title
Mechanical simulation study of reapproximated sternum rigidity comparing sternal fixation devices
Authors
Eiki Nagaoka
Hirokuni Arai
Publication date
16-08-2022
Publisher
Springer Nature Singapore
Keyword
Sternotomy
Published in
General Thoracic and Cardiovascular Surgery / Issue 2/2023
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-022-01856-w

Other articles of this Issue 2/2023

General Thoracic and Cardiovascular Surgery 2/2023 Go to the issue