Fixation of Traumatic Sternal Fractures Using SternaLock Plating System
A 43-year-old man, impacted in his chest by a car accident, complained of severe chest pain in his anterior chest wall with palpable sternal instability. Computed tomography (CT) of the chest showed a displaced compound mid-body sternal fracture (). Troubled with fracture of several cervical bones accompanied by sternal fracture, he was scheduled for open sternal fixation 3 days after the trauma because of combined operation with spine surgery. Open reduction and internal fixation of the sternum was performed using the SternaLock system (Biomet Microfixation Inc., Jacksonville, FL, USA).\nAfter a midline longitudinal incision over the sternum, the fracture site was carefully debrided of any fibrous union and old hematoma to expose healthy bone. Before plate fixation, manual reduction of the sternal fracture was assisted by the use of bone reduction forceps placed within the surrounding intercostal spaces. Three 4-holed straight plates were used vertically and horizontally due to compound sternal fracture (), manually contoured to the underlying sternum, and secured using self-drilling, self-tapping screws. The screw length was 10 mm, which was chosen by the thickness of the sternum (as measured on chest CT) at each point of screw placement. The wound was irrigated and closed. The patient was not discharged because he was receiving rehabilitation treatment for his leg, which had been paralyzed due to the cervical spine trauma. The 3-month follow-up demonstrated normal wound healing with no complaints of symptoms associated with instability. The repair was palpably stable and non-tender.