title: Potential risk of sternal wires.
abstract: OBJECTIVE
  To understand the potential fracture mechanism of sternal wires, we collected extracted stainless steel sternal wires from patients with sternal dehiscence following open-heart operations. Surface alterations and fractured ends of sternal wires were inspected and analyzed.
  
  
  METHODS
  Eight fractured and 12 non-fractured wires extracted from five patients (closure method: figure-of-eight or straight twisted; two without and three with mediastinitis) with mean implantation interval of 13.2+/-4.2 days (range 8-20 days) were studied by various techniques. The extracted wires were cleaned and the fibrotic tissues were removed. Irregularities and fractured ends were assayed by scanning electron microscopy and energy dispersive X-ray analysis (EDXA).
  
  
  RESULTS
  All examined fractured wires showed the presence of severe transversal cracks and crevice corrosion. EDAX revealed aluminum oxide inclusion on the fractured surface.
  
  
  CONCLUSIONS
  The synergic effect of stress and poor wire quality could be the precursors of material failure for the sternal wire.
authors.affiliation: Institute of Clinical Medicine, National Yang-Ming University School of Medicine, Taipei 112, Taiwan, ROC. ccshih@vghtpe.gov.tw
authors.forename: Chun-Che
authors.initials: CC
authors.lastname: Shih
authors.forename: Chun-Ming
authors.initials: CM
authors.lastname: Shih
authors.forename: Yea-Yang
authors.initials: YY
authors.lastname: Su
authors.forename: Shing-Jong
authors.initials: SJ
authors.lastname: Lin
mesh_terms: D001864:Bone Wires / Q000009:adverse effects*; D006348:Cardiac Surgical Procedures; D004868:Equipment Failure; D006801:Humans; D008855:Microscopy, Electron, Scanning; D010084:Oxidation-Reduction; D011859:Radiography; D013193:Stainless Steel; D013249:Sternum / Q000000981:diagnostic imaging / Q000601:surgery*; D013314:Stress, Mechanical; D013529:Surgical Wound Dehiscence / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D013536:Suture Techniques
chemical_list: D013193:Stainless Steel