title: Pain after median sternotomy: collateral damage or mitigatable byproduct?
abstract: BACKGROUND
  Postoperative acute pain can cause anxiety and decrease the quality of life in patients. Acute sternal bone pain after cardiac surgery can persist for long time.
  
  
  OBJECTIVE
  The aim of this study is to explore the relationships between the degree of sternal misalignment and the degree of acute sternal pain after coronary artery bypass grafting surgery (CABG).
  
  
  METHODS
  We retrospectively reviewed postoperative coronary computed tomographic (CT) angiography and medical records in 104 patients who received CABG between May 1, 2009 and January 31, 2011. CT scan was classified into five categories, and we compared the degree of misalignment and subjective pain via numerical rating scale (NRS) system.
  
  
  RESULTS
  Positive correlation was noted between NRS and the degree of sternal misalignment (Pearson correlation coefficient 0.660, p = 0.000).
  
  
  CONCLUSIONS
  Postoperative sternal pain is related to the degree of misalignment of the sternal halves. It would be appropriate for surgeons to approximate the sternal halves accurately to decrease the postoperative sternal wound pain in the first place.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Seoul St.Mary's Hospital, Seoul, Republic of Korea.
authors.forename: Mi Hyoung
authors.initials: MH
authors.lastname: Moon
authors.forename: Joon Kyu
authors.initials: JK
authors.lastname: Kang
authors.forename: Hwan Wook
authors.initials: HW
authors.lastname: Kim
authors.forename: Keon Hyun
authors.initials: KH
authors.lastname: Jo
authors.forename: Soo Hwan
authors.initials: SH
authors.lastname: Choi
authors.forename: Hyun
authors.initials: H
authors.lastname: Song
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods; D003324:Coronary Artery Disease / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D056346:Sternotomy / Q000009:adverse effects*; D013529:Surgical Wound Dehiscence / Q000150:complications* / Q000175:diagnosis; D014057:Tomography, X-Ray Computed