Longitudinal plate fixation technique after gross resection of the sternum or multiple sternal fracture

Bu yazida komplike sternal kapamalarda alternatif bir yol olarak longitudinal plak fiksasyonu teknigi kullanimi tanimlandi. Ocak 2008 Eylul 2011 tarihleri arasinda sternotomi sonrasi longitudinal rijit plak fiksasyonu yapilan hastalar retrospektif olarak degerlendirildi. Sternum debridmani sonrasi tama yakin sternal kaybi olan ya da coklu sternal kirigi bulunan yedi hasta (3 erkek, 4 kadin; ort. yas 64.42 yil; dagilim 30-74 yil) sternal ayrilma icin yuksek riskli olarak tanimlandi. Sternal kaynamamasi olan bu hastalarda 10 kez tekrar longitudinal plak fiksasyonu uygulandi. Hastalarin ikisinde (%29) tama yakin sternal kayip, besinde (%71) ise coklu sternal kirik vardi. Sternal instabilitesi olan bu hastalar on gogus duvarinda titanyum plaklar ve celik teller kullanilarak ameliyat edildi. Uzun donemde cok az rahatsizlik hissinin disinda, butun hastalarda ameliyat sonrasi gogus agrisi kayboldu. Tama yakin sternal kayip olgularinda ve coklu sternal kiriklarda, longitudinal sternal plak ve celik tellerin kullanimi efektif bir secenektir. Kullanimi kolay olan bu teknik, daha az komplikasyonla da iliskilidir. Anah tar soz cuk ler: Ayrilma; fiksasyon; plak; sternum. In this article, we described an alternative way for complicated sternal closure by using a longitudinal plate fixation technique. A retrospective analysis between January 2008 and September 2011 was performed on patients who received primary longitudinal rigid plate fixation after sternotomy. Seven patients (3 males, 4 females; mean age 64.4±14.3 years; range 30 to 74 years) with multiple sternal fractures or near-total loss after sternal debridement were defined as having high-risk for sternal dehiscence. We performed 10 longitudinally sternal plate refixation in these patients with sternal nonunion. Two patients (29%) had near-total sternal loss, while five patients (71%) had multiple sternal fractures. The patients suffering from sternal instability were operated using the titanium plates and steel wires for the anterior chest wall. Postoperative chest pain disappeared in all patients with only minor discomfort in the long-term. Longitudinal sternal plating and steel wires are an effective option for the treatment in patients with near-total sternal loss and multiple sternal fractures. This technique which is easy to use seems to be associated with fewer complications.