Biomechanical study of sternal closure using rigid fixation techniques in human cadavers.
BACKGROUND
We believe rigid plate fixation may be superior to wire fixation in sternal closure, as rigid fixation used in the craniofacial skeleton has shown greater stability, lower postoperative pain, and accelerated bone healing. We hypothesize that sterna fixed with titanium plates are more stable mechanically than sterna fixed with wires.


METHODS
The sterna from human cadavers were used in this two-phased study. Phase I compared wires to four-hole titanium straight plates. Phase II compared wires to four-hole titanium custom H plates. The sterna were tested biomechanically using all fixation methods.


RESULTS
Phase I showed no statistically significant difference in the stiffness or lateral displacement between the wired and straight plated sterna. Phase II showed a statistically significant greater stiffness (p < 0.05) and less lateral displacement (p < 0.05) in the custom plated sterna over the wired sterna.


CONCLUSIONS
Our results showed that custom titanium H plates were superior to wire fixation. Furthermore, our results established the importance of plate configuration in sternal fixation. Our study may have beneficial clinical implications, as decreased motion at the sternotomy site could mean less postoperative pain, a decreased incidence of infection, and accelerated bone healing.
Ozaki
W
W
Department of Surgery, University of Michigan Medical Center, Ann Arbor 48109-8063, USA.
Buchman
S R
SR
Iannettoni
M D
MD
Frankenburg
E P
EP
D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D001860:Bone Plates; D001864:Bone Wires; D002102:Cadaver; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008422:Materials Testing; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control; D018583:Pliability; D013193:Stainless Steel; D013249:Sternum / Q000601:surgery*; D013314:Stress, Mechanical; D013530:Surgical Wound Infection / Q000517:prevention & control; D014025:Titanium; D014945:Wound Healing
D013193:Stainless Steel; D014025:Titanium