title: Analysis of the sternum for sternal closure with bioabsorbable sternal pins.
abstract: OBJECTIVE
  Poly-L-lactide sternal pins have been reported to be beneficial for sternal closure. However, we sometimes experience a small sternum, and the size characteristics of the sternum have not been fully investigated. We analyzed size features of the sternum to determine the optimal size of sternal pin for sternal closure.
  
  
  METHODS
  Chest computed tomography scans were preoperatively obtained in 144 patients undergoing major cardiovascular surgery. We reviewed all scans at the level of the sternum, and measured the width of the bone marrow of the sternum on each computed tomography slice.
  
  
  RESULTS
  The mean values of bone marrow width of the sternal manubrium and body of male patients were significantly higher than those of females (manubrium: 38.6 ± 3.9 mm in males, 34.5 ± 3.3 mm in females, p < 0.0001; body: 23.4 ± 3.7 mm in males, 20.8 ± 2.8 mm in females, p < 0.0001). There was no correlation between the bone marrow width of the sternal body and body surface area in either males or females (males: r = 0.08, p = 0.45, females: r = 0.08, p = 0.58).
  
  
  CONCLUSIONS
  To select the appropriate size of sternal pin, preoperative measurement of the bone marrow width of the sternum is recommended because it cannot be predicted from body size.
authors.affiliation: Department of Cardiovascular Surgery, Sakurabashi-Watanabe Hospital, Osaka, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Kawamura
authors.forename: Takafumi
authors.initials: T
authors.lastname: Masai
authors.forename: Hajime
authors.initials: H
authors.lastname: Matsue
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Yoshikawa
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Sawa
mesh_terms: D020341:Absorbable Implants; D000368:Aged; D001830:Body Surface Area; D001858:Bone Nails; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011091:Polyesters / Q000737:chemistry; D011474:Prosthesis Design; D012737:Sex Factors; D056346:Sternotomy; D013249:Sternum / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D058106:Wound Closure Techniques / Q000295:instrumentation*
chemical_list: D011091:Polyesters; C033616:poly(lactide)
keywords: Absorbable implants; bone nails; poly(lactide); sternotomy; sternum