Titanium Transverse Plate Fixation: a New Solution for Old Sternal Problems

To evaluate our initial results with the titanium transverse plate fixation system of the sternum in four patients. Two patients with late dehiscence and persistent instability of the sternum after cardiac surgery were treated with refixation by titanium transverse plates and screws. Two patients were treated with the same refixation method after pre-treatment with debridement, antibiotic therapy and vacuum-assisted closure therapy for extensive mediastinitis. All four patients healed without complications. The mean postoperative length of stay was 17,3 days (range 7-44). The instability and/or pain disappeared in all patients. The postoperative imaging showed good positioning of the osteosynthesis material. There was no re-infection in patients with mediastinitis. The titanium transverse plate fixation system is a very promising adjunct to the armamentarium of the cardio-thoracic surgeon for treatment of sternal problems, including dehiscence and fractures, even when mediastinitis is involved. It offers more stability compared to simple rewiring, without the need for extensive retrosternal dissection.