title: Failure analysis of explanted sternal wires.
abstract: To classify and understand the mechanisms of surface damages and fracture mechanisms of sternal wires, explanted stainless steel sternal wires were collected from patients with sternal dehiscence following open-heart surgery. Surface alterations and fractured ends of sternal wires were examined and analyzed. Eighty fractured wires extracted from 25 patients from January 1999 to December 2003, with mean implantation interval of 55+/-149 days (range 5-729 days) after cardiac surgery, were studied by various techniques. The extracted wires were cleaned and the fibrotic tissues were removed. Irregularities and fractured ends were assayed by a scanning electron microscopy. After stereomicroscopy and documentation, the explants were cleaned with 1% sodium hypochlorite to remove the blood and tissues and was followed by cleaned with deionized water and alcohol. The explants were examined by stereomicroscopy, and irregularities on surface and fracture surfaces of sternal wires were assayed by scanning electron microscopy, energy dispersive X-ray analysis (EDAX) and X-ray mapping. The explants with surrounding fibrotic tissue were stained and examined with stereomicroscopy and transmission electronic microscopy. Corrosion pits were found on the surface of explanted sternal wires. EDAX and X-ray mapping examinations revealed diminution of nickel concentration in the severely corroded pits on sternal wires. A feature of transgranular cracking was observed for stress corrosion cracking and striation character for typical corrosion fatigue was also identified. TEM examination of tissue showed the metallic particles in phagolysosomes of macrophages inside the surrounding sternal tissue. The synergic effect of hostile environment and the stress could be the precursors of failures for sternal wires.
authors.affiliation: Graduate Institute of Medical Sciences, School of Medicine, Taipei Medical University, Taipei 110, Taiwan. paul.hank@msa.hinet.net
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
authors.forename: Chun-Che
authors.initials: CC
authors.lastname: Shih
mesh_terms: D001672:Biocompatible Materials / Q000009:adverse effects / Q000032:analysis / Q000737:chemistry; D001864:Bone Wires / Q000009:adverse effects*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation; D003343:Corrosion; D004868:Equipment Failure; D019544:Equipment Failure Analysis / Q000379:methods*; D006801:Humans; D008422:Materials Testing; D013193:Stainless Steel / Q000009:adverse effects* / Q000737:chemistry; D013249:Sternum / Q000473:pathology* / Q000601:surgery*; D013499:Surface Properties; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000473:pathology*
chemical_list: D001672:Biocompatible Materials; D013193:Stainless Steel