Semin Plast Surg. 2011 Feb;25(1):98-106. doi: 10.1055/s-0031-1275176.
Although rare, sternal nonunion after median sternotomy or traumatic injury is associated with a high rate of morbidity. Pain and sternal clicking are two of the most common complaints and reasons these patients seek evaluation and treatment. Diagnosis of sternal nonunion is based on a thorough history and physical examination and can be confirmed with subsequent radiographic imaging. The treatment for symptomatic sternal nonunion requires stable fixation of the bony fragments and chest wall after the debridement of all nonviable bony and soft tissue by the cardiothoracic or reconstructive surgery team. Multiple fixation techniques have been described and incorporate a wide variety of materials including combinations of wires, cables, pins, bands, staples, and plates. Most recently, several new commercially available plating systems have demonstrated low recurrence and complication rates and resolution of the patient's symptoms on follow-up evaluation. Included in this review are three cases demonstrating the management of symptomatic sternal nonunion using these new techniques and review the history, diagnosis, risk factor, and classification, as well as several of the previously described fixation methods.
胸骨切开术或创伤后胸骨不愈合虽然罕见，但与高发病率相关。疼痛和胸骨弹响是最常见的两种症状，也是这些患者寻求评估和治疗的原因。胸骨不愈合的诊断基于详细的病史和体格检查，并可通过随后的影像学检查来确认。有症状的胸骨不愈合的治疗需要在心胸外科或重建外科团队清除所有无活力的骨和软组织后，对骨碎片和胸壁进行稳定固定。已经描述了多种固定技术，这些技术结合了各种材料，包括钢丝、电缆、销钉、带、订书钉和钢板的组合。最近，几种新的商业上可获得的接骨板系统已显示出较低的复发和并发症率，并在随访评估中解决了患者的症状。本综述包括三个使用这些新技术治疗有症状的胸骨不愈合的病例，并回顾了病史、诊断、危险因素和分类，以及以前描述的几种固定方法。
