title: Sternal talon offers a solution for secondary sternum osteosynthesis in patients with nonunion.
abstract: BACKGROUND
  Median sternotomy may be associated with postoperative complications such as nonunion after conventional metal wire closure. The Sternal Talon device (KLS Martin, Jacksonville, FL) has recently been introduced as an alternative for osteosynthesis after median sternotomy and may also be beneficial for patients with persistent sternal nonunion.
  
  
  METHODS
  A consecutive series of 24 patients underwent Sternal Talon repair for sternal nonunion or acute mediastinitis, or both, after sternal wire closure. Patient data--including demographics, surgical history, and indication for operation, as well as outcomes--were obtained and analyzed by retrospective chart review.
  
  
  RESULTS
  The average patient age was 61.3 years and 23 patients were men (95.8%). The most common median sternotomy procedure was coronary artery bypass grafting (CABG) in 19 patients (79.2%). Secondary closure using the Sternal Talon was indicated for sternal nonunion or infection, or both, in all patients. Eight patients underwent simultaneous muscle flap procedures during the placement of the Sternal Talon (33.3%). Sternal union was eventually achieved in 23 of 24 patients (95.8%). Subsequent reoperation was required in 4 patients (16.7%).
  
  
  CONCLUSIONS
  The data presented suggest that the osteosynthesis using the Sternal Talon device is a safe and effective modality for treating symptomatic sternal nonunion or acute dehiscence associated with infection (mediastinitis.).
authors.affiliation: Division of Plastic, Reconstructive, Maxillofacial, and Oral Surgery and Department of Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Michael R
authors.initials: MR
authors.lastname: DeLong
authors.affiliation: Division of Plastic, Reconstructive, Maxillofacial, and Oral Surgery and Department of Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Duncan B
authors.initials: DB
authors.lastname: Hughes
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Jeffrey G
authors.initials: JG
authors.lastname: Gaca
authors.affiliation: Division of Plastic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: John P
authors.initials: JP
authors.lastname: Fischer
authors.affiliation: Division of Plastic, Reconstructive, Maxillofacial, and Oral Surgery and Department of Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Bond
authors.affiliation: Division of Cardiovascular Surgery and Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: W Clark
authors.initials: WC
authors.lastname: Hargrove
authors.affiliation: Division of Cardiovascular Surgery and Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Pavan
authors.initials: P
authors.lastname: Atluri
authors.affiliation: Division of Plastic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; Department of Orthopedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: L Scott
authors.initials: LS
authors.lastname: Levin
authors.affiliation: Division of Plastic, Reconstructive, Maxillofacial, and Oral Surgery and Department of Surgery, Duke University Medical Center, Durham, North Carolina. Electronic address: detlev.erdmann@duke.edu.
authors.forename: Detlev
authors.initials: D
authors.lastname: Erdmann
mesh_terms: D001864:Bone Wires; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D013249:Sternum / Q000601:surgery*; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000601:surgery*; D013530:Surgical Wound Infection / Q000150:complications* / Q000601:surgery; D013536:Suture Techniques / Q000295:instrumentation*; D035441:Thoracic Wall / Q000601:surgery*; D016896:Treatment Outcome