Triple Barrel Free Fibula Flap for Sternal Stabilization: A Case Report

Area of Science:

• Orthopedic Surgery
• Thoracic Surgery
• Biomaterials Science

Background:

• Sternal non-union is a rare but morbid complication following median sternotomies in cardiac surgery.
• It leads to significant sternal instability, pain, and chest wall clicking, impacting patient quality of life.

Observation:

• Diagnosis is typically confirmed via computed tomography (CT) demonstrating a gap between the sternal halves.
• Surgical correction presents challenges in achieving both functional and aesthetic restoration of the thoracic cage.

Findings:

• A novel surgical technique for sternal instability reconstruction is presented, utilizing a triple-barrel vascularized free fibula flap.
• This flap is secured with rib titanium plates, providing robust and enduring stability.

Implications:

• This approach aims to reconstruct the thoracic cage, promoting biomimetic principles and preserving vital cardiac and pulmonary functions.
• The technique offers a promising solution for rigid, long-lasting sternal stability while maintaining chest wall biomechanics and aesthetic outcomes.