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The use of suture anchors for sternal nonunion as a new technical approach (Demircin-Dogan technique).

Dogan OF, Demircin M, Duman U, Ozsoy F, Acaroglu E.

Department of Cardiovascular Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey. ofdogan@hacettepe.edu.tr

OBJECTIVES: Various comparative studies and techniques have been described for median sternotomy closure in the literature, previously. However, some patients are still under risk of sternal dehiscence, malunion or nonunion due to intrinsic or extrinsic factors after median sternotomy closure. Sternal nonunion described as sternal pain, with clicking, instability, or both for more than 3 months in the absence of infection, is an uncommon complication of midline sternotomy incision. To date, only a few studies have addressed the entity of sternal nonunion and its treatment. MATERIAL AND METHOD: The suture anchor system has been described for the fixation of tendons or ligaments to the bone in the orthopedic, and then in cardiac surgery for closure of sternum. In the present study, we used different methods for correction and reduction of sternal nonunion with the use of suture anchors and it accompanied steel wires as an alternative technique in a male patient after coronary artery bypass grafting. RESULTS: There was no complication due to suture anchors. Sternal stability, reduction, and fixation were achieved successfully. CONCLUSION: Sternal nonunion and dehiscence may be the cause of prolonged hospitalization and increased mortality and morbidity if the patient is not treated surgically. This device may protect the wire from cutting into the sternal bone because the thoracal lateral enforcement may be decreased by the devices when the patient is breathing, and with upper extremity movement. This technique can be used easily, safely, and effectively in the repair of sternal nonunion.
OBJECTIVES: Various comparative studies and techniques have been described for median sternotomy closure in the literature, previously. However, some patients are still under risk of sternal dehiscence, malunion or nonunion due to intrinsic or extrinsic factors after median sternotomy closure. Sternal nonunion described as sternal pain, with clicking, instability, or both for more than 3 months in the absence of infection, is an uncommon complication of midline sternotomy incision. To date, only a few studies have addressed the entity of sternal nonunion and its treatment. MATERIAL AND METHOD: The suture anchor system has been described for the fixation of tendons or ligaments to the bone in the orthopedic, and then in cardiac surgery for closure of sternum. In the present study, we used different methods for correction and reduction of sternal nonunion with the use of suture anchors and it accompanied steel wires as an alternative technique in a male patient after coronary artery bypass grafting. RESULTS: There was no complication due to suture anchors. Sternal stability, reduction, and fixation were achieved successfully. CONCLUSION: Sternal nonunion and dehiscence may be the cause of prolonged hospitalization and increased mortality and morbidity if the patient is not treated surgically. This device may protect the wire from cutting into the sternal bone because the thoracal lateral enforcement may be decreased by the devices when the patient is breathing, and with upper extremity movement. This technique can be used easily, safely, and effectively in the repair of sternal nonunion.

Heart Surg Forum. 2005;8(5):E364-9.

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Bu makaleden alıntı yapmak için alıntı yapılan yazıya aşağıdaki ibare eklenmelidir : "The use of suture anchors for sternal nonunion as a new technical approach (Demircin-Dogan technique)." başlıklı makalenin tüm hakları yazarı Doç.Dr.Ömer Faruk DOGAN'e aittir ve makale, yazarı tarafından TavsiyeEdiyorum.com (http://www.tavsiyeediyorum.com) kütüphanesinde yayınlanmıştır. Bu ibare eklenmek şartıyla, makaleden Fikir ve Sanat Eserleri Kanununa uygun kısa alıntılar yapılabilir, ancak yazarının izni olmaksızın makalenin tamamı başka bir mecraya kopyalanamaz veya başka yerde yayınlanamaz.

Doç.Dr.Ömer Faruk DOGAN Tarafından Yazılan Diğer Makaleler: Effect Of Cardiopulmonary Bypass On Plasma Levels Of Lipoprotein (A) İn Hypercholesterolemic Patients A New Technical Approach For Sternal Closure With Suture Anchors (Dogan Technique). Surgical Management Of İnfants With Congenital Lobar Emphysema And Concomitant Congenital Heart Disease. Assessment Of The Radial Artery And Hand Circulation By Computed Tomography Angiography: A Pilot Study. Comparison Of The Pretreatment Effects Of Mixed Vasodilators (3-D Solution) On Radial And İnternal Thoracic Arteries By Using A 3-Dimensional Anaglyph Electron Microscope Technique. The Changes And Effects Of The Plasma Levels Of Tumor Necrosis Factor After Coronary Artery Bypass Surgery With Cardiopulmonary Bypass. Peripheral Gangrene Associated With Kawasaki Disease And Successful Management Using Prostacycline Analogue: A Case Report. Demonstration Of Coronary Arteries And Major Cardiac Vascular Structures İn Congenital Heart Disease By Cardiac Multidetector Computed Tomography Angiography. Predictive Significance Of Plasma Levels Of İnterleukin-6 And High-Sensitivity C-Reactive Protein İn Atrial Fibrillation After Coronary Artery Bypass Surgery. Preoperative Fibrinogen Levels As A Predictor Of Postoperative Bleeding After Open Heart Surgery.