Bespoke Three-Dimensional Modeling for Reconstruction of a Complex Poststernotomy Chest Wall Defect

Noninfectious chest wall defects after sternotomy are most commonly related to sternal malunion but encompass a heterogenous spectrum of abnormalities that may extend beyond the sternotomy itself. An individualized approach to reconstruction is essential. Historically this has required intraoperative anatomic assessment and decision-making, which in turn may compromise operative times and technical results. We present an unusual case of costochondral-sternal dissociation after routine sternotomy that was addressed with the aid of preoperative 3-dimensional modeling and custom plate design. We demonstrate that the use of this approach resulted in a first-attempt successful reconstruction with no perioperative complications.