Plass A, Emmert M Y, Pilsl M, Salzberg S P, Genoni M, Falk V, Grunenfelder J
Clinic for Cardiovascular Surgery, University Hospital Zurich, Zurich, Switzerland.
Thorac Cardiovasc Surg. 2011 Feb;59(1):30-3. doi: 10.1055/s-0030-1250390. Epub 2011 Jan 17.
Titanium plate osteosynthesis (Synthes) is an alternative option for sternal closure. The indications and time point of application are still debated. This study investigated the application and feasibility of this technique after median sternotomy.
Forty-one patients (29 M/12F, mean age 63 ± 17 years) received the plate system for complicated sternal conditions. Indications, intraoperative course and postoperative follow-up were assessed.
Sternal deformity was present in 5 % (2/41), sternal fractures in 17 % (7/41), bone defect in 12 % (5/41), wire loosening in 39 % (16/41) and pseudoarthrosis in 27 % (11/41). 54 % (22/41) of patients showed concomitant sternal infection. Two intraoperative complications were noted: mammary artery injury (1 patient), pleural injury (1 patient). At discharge the patients reported no pain (90 %, 37/41) or only occasional discomfort (10 %, 4/41). Postoperative complications were subcutaneous hematoma in 12 % (5/41), seroma in 12 % (5/41) and sternal reinfection in 7 % (3/41). 12 % (5/41) showed occasional discomfort and 7 % (3/41) had persistent pain leading to plate removal.
The Titanium Sternal Fixation System is comfortable and easy to use. It can be used to treat a wide spectrum of indications, especially for pseudoarthrosis, an entity which has not yet received sufficient attention.
钛板内固定术（Synthes）是胸骨闭合的一种替代选择。其应用指征和时间点仍存在争议。本研究调查了正中开胸术后该技术的应用及可行性。
41例患者（29例男性/12例女性，平均年龄63±17岁）因复杂的胸骨情况接受了钢板系统治疗。评估了指征、术中过程及术后随访情况。
5%（2/41）存在胸骨畸形，17%（7/41）存在胸骨骨折，12%（5/41）存在骨缺损，39%（16/41）存在钢丝松动，27%（11/41）存在假关节形成。54%（22/41）的患者伴有胸骨感染。术中记录到2例并发症：乳内动脉损伤（1例患者）、胸膜损伤（1例患者）。出院时，患者报告无疼痛（90%，37/41）或仅有偶尔不适（10%，4/41）。术后并发症包括皮下血肿12%（5/41）、血清肿12%（5/41）和胸骨再感染7%（3/41）。12%（5/41）表现为偶尔不适，7%（3/41）有持续疼痛导致钢板取出。
钛胸骨固定系统使用舒适且简便。它可用于治疗多种指征，尤其是对于尚未得到充分关注的假关节形成。
