Real-time ultrasound assessment of sternal stability in adhesive-enhanced sternal closure

Doa El-Ansary, Sulakshana Balachandran, Alistair Royse, Kathryn King-Shier, Adam Bryant, Linda Denehy, Paul Fedak
2016 Journal of Translational Science  
Purpose: Conventional sternal closure by wire cerclage is the current standard of care worldwide but can result in pathologic sternal displacement and persistent sternal pain. The aim of this case report was to quantify sternal separation and sternal micro-motion in two patients following conventional wire cerclage alone (patient 1) and adhesive-enhanced closure on a platform of wire cerclage (patient 2) respectively. Description: Sternal separation and micro-motion was measured using real-time
more » ... red using real-time ultrasound. Pain and sternal stability were assessed using a Visual Analogue Scale (VAS) and the Sternal Instability Scale (SIS) respectively. Evaluation: Patient 1 demonstrated sternal separation and micro-motion that was evident in the coronal and sagittal planes during upper limb movements and cough. Patient 2 demonstrated no sternal separation or micro-motion post-operatively with cortical bone bridging the sternal edges. Conclusions: Real-time ultrasound is a non-invasive, valid and reliable measurement tool for quantification of sternal separation and micro-motion; monitoring of sternal healing and evaluation of sternal closure techniques. Future research investigating sternal closure in particular adhesive-enhanced closure is warranted in a larger population. Figure 5. Patient 2(enhanced-adhesive on a platform of wire cerclage sternal closure) during a cough at 6 weeks post-operatively. Bone union evident. Figure 6. Patient 2(enhanced-adhesive on a platform of wire cerclage sternal closure) during a cough at 3 months post-operatively. Bone union evident.
doi:10.15761/jts.1000115 fatcat:zaopvub7rjd6bhgm3lqizy3dri