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Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling

Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling

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Steinmann pin augmentation versus locking plate constructs.

Jeremy Ruskin¹, Paolo Caravaggi², Kathleen S Beebe¹

¹Department of Orthopaedic Surgery, Rutgers, The State University of New Jersey, New Jersey Medical School, Newark, NJ, 07103, USA.

Journal of Orthopaedics and Traumatology : Official Journal of the Italian Society of Orthopaedics and Traumatology

|February 18, 2016

Summary

This summary is machine-generated.

Locking plate constructs provide greater stiffness for proximal tibia reconstruction after aggressive bone tumor resection compared to Steinmann pin augmentation. This offers a more stable option for complex bone defect repair.

Keywords:

Giant cell tumor Locking plate Oncology Steinmann pin

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Area of Science:

Orthopedic Surgery
Biomedical Engineering
Oncology

Background:

Aggressive bone neoplasms like giant cell tumors necessitate proximal tibia resection, creating large defects.
Reconstruction typically involves poly(methyl methacrylate) (PMMA) packing and internal fixation.

Purpose of the Study:

To compare the stiffness of Steinmann pin augmentation versus locking plate constructs for proximal tibia reconstruction.

Main Methods:

Massive bone defects were created in fresh frozen tibias.
Tibias were reconstructed using either Steinmann pins with PMMA or a locking plate with PMMA.
Construct stiffness and fatigue properties were tested mechanically.

Main Results:

Locking plate constructs demonstrated significantly greater stiffness (801.8 N/mm) than Steinmann pin constructs (646.5 N/mm).
While permanent deformation was similar, two Steinmann pin constructs failed due to excessive displacement.

Conclusions:

Locking plate fixation offers a stiffer and potentially more reliable reconstruction for proximal tibia defects compared to Steinmann pins.
This finding has implications for improving surgical outcomes in patients requiring extensive bone defect repair.