Konagai N, Ishimaru S, Maeda M, Tani D, Sudoh H, Kudoh T
Department of Cardiovascular Surgery, Hachioji Medical Center of Tokyo Medical College, Japan.
Kyobu Geka. 1997 Aug;50(9):748-50.
In this report, 15 cases using straight staple (group A) and 35 cases using barbed staple (group B) were compared for the purpose of investigating efficacy for median sternal closure. The staples were placed by a Stapilizer powered metaphyseal staple system following partial transsternal fixation with two wires. As a means of assessing the status of back out, which is a major cause of poor fixation, the back out rate (BOR) was measured on lateral sternal radiographies. The average BOR was found to be 33.8% in group A and 21.2% in group B (p < 0.001). Barbed staples seemed to be more useful for sternal fixation than straight staples. This method of applying barbed staples had the advantages of speed, ease of insertion and noninvasion of the retrosternal region. It should be recommended in cases with severe adhesion of the retrosternal region after coronary operation.
在本报告中，为研究正中胸骨闭合的疗效，对15例使用直钉（A组）和35例使用倒刺钉（B组）的病例进行了比较。在用两根钢丝进行部分胸骨固定后，使用Stapilizer动力干骺端钉系统放置钉子。作为评估固定不佳的主要原因——钉子退出情况的一种方法，通过胸骨侧位X线片测量钉子退出率（BOR）。发现A组的平均BOR为33.8%，B组为21.2%（p<0.001）。倒刺钉似乎比直钉在胸骨固定方面更有用。这种应用倒刺钉的方法具有速度快、插入容易且不侵犯胸骨后区域的优点。对于冠状动脉手术后胸骨后区域严重粘连的病例，应推荐使用。
