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A biomechanical comparison of three sternotomy closure techniques
David J Cohen1, Lanny V Griffin
1Cardiothoracic Surgery Service, Brooke Army Medical Center, US Army Institute of Surgical Research, Fort Sam Houston, Texas 78234-6200, USA. david.cohen@cen.amedd.army.mil
The Annals of Thoracic Surgery
|February 16, 2002
Summary
The Pectofix Dynamic Sternal Fixation (DSF) plate system provides superior rigidity and resistance to failure compared to traditional wires and cables for sternal closure. This dynamic fixation offers significant biomechanical advantages in preventing implant cutout.
Area of Science:
- Biomedical Engineering
- Orthopedic Surgery
- Materials Science
Background:
- Sternotomy closure is critical for post-operative recovery.
- Traditional figure-of-eight wires have limitations in providing sternal stability.
- Novel fixation techniques aim to improve biomechanical performance.
Purpose of the Study:
- To biomechanically compare the strength and stiffness of three sternotomy closure techniques.
- Evaluate figure-of-eight stainless-steel wires, Pectofix Dynamic Sternal Fixation (DSF) plates, and stainless-steel cables.
- Assess performance under clinically relevant loading conditions.
Main Methods:
- Polyurethane foam sternal models simulating cancellous bone were used.
- Models were repaired with one of three fixation techniques after longitudinal division.
- Materials testing system applied increasing force to determine failure points, strength, and stiffness.
Main Results:
- The DSF plate system demonstrated greater rigidity than wires or cables in distraction and transverse shear modes.
- DSF plates showed a 25% improvement in yield resistance against transverse shear compared to wires.
- DSF plates significantly reduced implant cutout under loading compared to cables and wires.
Conclusions:
- Both the DSF plate system and stainless-steel cables offer advantages over figure-of-eight wires.
- The DSF system provides enhanced rigidity and resistance to sternal separation.
- These findings suggest improved sternal stability with advanced fixation methods.