Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, New York.
Universidad Central del Caribe School of Medicine, Bayamón, Puerto Rico.
JBJS Case Connect. 2023 Dec 22;13(4). doi: e23.00406. eCollection 2023 Oct 1.
Given the rare incidence of sternal nonunion after traumatic injury, literature describing the management of posttraumatic sternal reconstruction is limited. We present a case of a 54-year-old man with a history of traumatic chest wall injury with multiple unsuccessful attempts at sternal repair who presented with chronic sternal nonunion and persistent bone defect. Sternal reconstruction using a vascularized double-barrel free fibula flap with rigid fixation in multiple planes was performed, with confirmed bony union at 6 months.
This novel approach to sternal nonunion management allowed effective bridging of posttraumatic sternal bone defects while facilitating osseous integration and long-term stabilization.
外伤性胸骨不愈合极为罕见，因此，描述外伤性胸骨重建后处理的文献有限。我们报告了 1 例 54 岁男性，既往有外伤性胸壁损伤病史，曾多次尝试胸骨修复但均未成功，此次因慢性胸骨不愈合和持续性骨缺损就诊。采用带血管蒂的双段游离腓骨瓣进行胸骨重建，并在多个平面行刚性固定，6 个月时确认骨性愈合。
这种治疗胸骨不愈合的新方法可有效桥接外伤性胸骨骨缺损，同时促进骨整合和长期稳定。
