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Effect of internal fixation of the sternum using bioabsorbable pins in small children

Makoto Ando1

  • 1Department of Cardiovascular Surgery, Kanazawa Medical University, Kanazawa, Japan.

Journal of Cardiac Surgery
|August 3, 2019
PubMed

Insights

A sternal pin improves sternal healing after midline sternotomy in children. This surgical technique reduces sternal deformity, ensuring better outcomes compared to traditional methods.

Area of Science:

  • Pediatric surgery
  • Thoracic surgery
  • Medical imaging

Background:

  • Sternal closure after median sternotomy is crucial for pediatric cardiac surgery.
  • Traditional sternal approximation may lead to deformities like protrusion or excavation.

Purpose of the Study:

  • To evaluate the effectiveness of sternal pins in pediatric patients undergoing median sternotomy.
  • To assess sternal healing and alignment using computed tomography (CT) scans.

Main Methods:

  • Retrospective analysis of pediatric patients undergoing first-time median sternotomy (April 2012 - December 2014).
  • Propensity score matching created control and sternal pin groups (17 patients each).
  • CT scans at 6 months post-surgery measured sternal reflection angle and Haller index.

Main Results:

  • Sternal pin group showed significantly less variation in sternal reflection angles (SD 10.2° vs. 31.6°).
  • Fewer patients in the sternal pin group experienced sternal excavation (1/17 vs. 7/17).
  • Sternal pin group demonstrated reduced Haller index variability and significant differences at the ninth vertebral level.

Conclusions:

  • Sternal pins are effective in stabilizing the sternum after median sternotomy in children.
  • This technique reduces sternal deformity, including protrusion and excavation.
  • CT imaging confirms improved sternal alignment with sternal pin use.
Abstract

Keywords:
chest deformitycongenital heart diseasesternal pin

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