A Novel Surgical Technique for Transverse Sternal Bone Defects Using Flexible Intramedullary Nailing

Abstract

Transverse sternal bone defects as a result of surgery or trauma remain an important clinical condition with serious sequelae. Patients sometimes complain of local pain during movement and breathing. Usually, defects are filled with prosthetic materials which remain permanently in situ. Small defects can be treated with autogenous bone grafts, whereas large defects are difficult to stabilize with common osteosynthetic techniques. Here, we report a new surgical technique using flexible intramedullary nailing (“Elastic Stable Intramedullary Nailing” - ESIN or “Embrochage Centro-Medullaire Elastique Stable” - ECMES) to stabilize a sternal defect after surgical removal of an osteochondral lesion. The defect was bridged by two elastic titanium nails and an autogenous corticocancellous bone graft. This new surgical technique showed a good clinical and functional outcome.

Sternal bone defects - flexible intramedullary nailing - autogenous bone graft

References

• 1 Chapelier A R, Missana M C, Couturaud B. et al . Sternal resection and reconstruction for primary malignant tumors.  Ann Thorac Surg. 2004;  77 1001-1006
• 2 Barry M, Paterson J MH. Flexible intramedullary nails for fractures in children.  J Bone Joint Surg Br. 2004;  86 947-953
• 3 Kettler M, Schieker M, Braunstein V, König M, Mutschler W. Elastic stable intramedullary nailing (ESIN) for displaced midclavicular fractures with titanium nails.  Akt Trauma. 2005;  35 1-5
• 4 Bertin K C, Rice R S, Doty D B, Jones K W. Repair of transverse nonunions using metal plates and autologenous bone graft.  Ann Thorac Surg. 2002;  73 1661-1662