The role of the bone-gallium scan in sternal osteomyelitis

Sternal osteomyelitis is an uncommon but serious complication of the median sternotomy incision. Between 1982 and 1990, 160 patients with sternal osteomyelitis and wound dehiscence were treated with sternal debridement and pectoral muscle flap closure at The Toronto Hospital. Most of these wound infections were clinically obvious, and the need for surgical treatment apparent. In a small number of patients, however, the extent of the infection was more difficult to determine clinically. In this subset of patients, the interpretation of the bone-gallium scan was important in determining the presence or absence of bone infection and the probability of successful treatment without surgery. In this study, we review our findings at the time of surgery and compare them with the preoperative information available from the bone-gallium scan. The limited literature on this topic is reviewed. In this group of patients, we found the bone-gallium scan was not helpful in clinical management.