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Related Experiment Video

Updated: Feb 12, 2026

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Rigid Plate Fixation Versus Wire Cerclage for Sternotomy After Cardiac Surgery: A Meta-Analysis.

Derrick Y Tam¹, Rashmi Nedadur², Monica Yu³

¹Division of Cardiac Surgery, Department of Surgery, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.

The Annals of Thoracic Surgery

|March 27, 2018

Summary

Rigid plate fixation for sternal closure may reduce sternal complications in high-risk patients and improve survival. Further randomized trials are needed to confirm these benefits for sternotomy closure.

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Area of Science:

Cardiothoracic Surgery
Surgical Innovation
Evidence-Based Medicine

Background:

Traditional sternal closure after sternotomy uses wire cerclage.
Emerging evidence suggests rigid plate fixation may lower sternal complication rates.

Purpose of the Study:

To compare the efficacy of rigid plate fixation versus wire cerclage for sternal closure in cardiac surgery patients.
To evaluate sternal complications, mortality, and length of stay.

Main Methods:

A systematic review and random effects meta-analysis of studies comparing rigid plate fixation and wire cerclage.
Searched Medline and Embase databases from inception to February 2017.
Primary outcome: sternal complications (infection, instability); Secondary outcomes: mortality, length of stay.

Main Results:

Included 3 RCTs (427 patients) and 5 observational studies (1,025 patients).
No significant overall difference in sternal complications, but reduced in high-risk patients (p=0.03).
Rigid plate fixation showed reduced perioperative mortality (p=0.04) and shorter hospital stays in observational studies (p=0.0002).

Conclusions:

Rigid plate fixation may decrease sternal complications in high-risk patients, improve survival, and shorten hospital stays.
Results are influenced by observational studies; more RCTs are needed.
Further research is recommended to validate rigid plate fixation for primary sternotomy closure.