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Updated: Jun 21, 2026

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

Published on: January 5, 2015

[Atrophic sternum nonunion-Case report based on the nonunion scoring system]

Benedikt J Braun¹, Steven C Herath², Mika F R Rollmann²

¹Klinik für Unfall- und Wiederherstellungschirurgie an der Eberhard Karls Universität Tübingen, BG Klinik Tübingen, Schnarrenbergstr. 95, 72076, Tübingen, Deutschland. bbraun@bgu-tuebingen.de.

Unfallchirurgie (Heidelberg, Germany)

|February 8, 2022

Abstract:

Nonunions after median sternotomy are rare and usually respond well to surgical treatment. Recalcitrant nonunions despite surgical treatment require a comprehensive mechanical and biological treatment strategy to achieve an adequate functional result for the patient. We demonstrate the case of a 4-year recalcitrant atrophic nonunion. Through a surgical approach guided by the criteria of the nonunion scoring system (NUSS) successful healing was achieved. Our strategy as well as the treatment course are presented.

Keywords:

Breastbone Cutibacterium acnis Failed Bone Healing Locking sternum plates NUSS score

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The Thoracic Cage: Sternum

The Thoracic Cage: Sternum

The thoracic or rib cage forms the body's thorax (chest) portion. Its primary function in the body is to protect vital organs in the thoracic cavity, such as the heart and the lungs. It consists of 12 pairs of ribs with their costal cartilages and the sternum. The ribs are anchored posteriorly to the 12 thoracic vertebrae (T1-T12).
The sternum is the elongated bony structure on the anterior side of the thoracic cage. It consists of three parts: the manubrium, the body, and the xiphoid process.

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