[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
Summary
Recalcitrant nonunions after median sternotomy, though rare, can be successfully treated with a comprehensive mechanical and biological strategy. A case study highlights healing achieved through a surgical approach guided by the nonunion scoring system (NUSS).
Area of Science:
- Cardiothoracic Surgery
- Orthopedic Surgery
- Regenerative Medicine
Background:
- Nonunions following median sternotomy are infrequent but can present challenges in treatment.
- Recalcitrant cases necessitate advanced strategies beyond standard surgical intervention.
- Atrophic nonunions require a combined mechanical and biological approach for effective healing.
Observation:
- A 4-year history of recalcitrant atrophic nonunion of the sternum was observed.
- The patient's nonunion had previously resisted standard surgical treatments.
- A detailed assessment using the nonunion scoring system (NUSS) guided the subsequent treatment plan.
Findings:
- A comprehensive surgical strategy, incorporating mechanical stabilization and biological enhancement, was implemented.
- The treatment protocol was specifically tailored based on the NUSS criteria for the patient's condition.
- Successful healing of the recalcitrant sternal nonunion was achieved following this tailored approach.
Implications:
- This case demonstrates the efficacy of a systematic, scoring-system-guided approach for complex sternal nonunions.
- The findings suggest that integrating mechanical and biological treatments is crucial for recalcitrant cases.
- This strategy offers a potential pathway to improved functional outcomes for patients with challenging nonunions.
