Primary tubercular osteomyelitis of sternum is a rare clinical entity and involvement of manubrio-sternal joint is even rarer, with only few cases reported in the literature. Tuberculous sternal involvement is seen in approximately 1% of all skeletal TB cases. We report an unusual case of primary manubrio-sternal joint tuberculosis presenting as vague anterior chest wall swelling and pain. ESR ...

Deep sternal wound infection (DSWI) is a feared complication following cardiac surgery. This study describes clinical, microbiological, and treatment outcomes of DSWI and determines risk factors for complications. Of 55 patients with DSWI, 66% were male and mean age was 68.2 years. Initial sternotomy was for coronary artery bypass graft in 49% of patients. Sternal debridement at mean 25.4±18.3 ...

We retrospectively collected and analysed data from patients with sternal wound infections between 1995 and 2001, which were treated with different wound management strategies, and compared them with our patients from 2002 to 2011, who were treated with the sternal negative pressure wound therapy (NPWT). From 1995 to 2001, a total of 198 patients (group A) with a mean age of 65 ± 10 years devel...

BACKGROUND We sought to assess the efficiency of two different sternal closure techniques in preventing sternal wound complications (SWC). A cost analysis was also considered. METHODS Between January 2008 and April 2010, 1,644 consecutive cardiac surgery patients who underwent cardiac surgery in our institute were prospectively collected. A total of 1,072 patients received a standard paraster...

Osteoporosis often results in fractures, deformity and disability. A rare but potentially challenging complication of osteoporosis is a sternal insufficiency fracture. This case report details a steroid-induced osteoporotic male who suffered a sternal insufficiency fracture after minimal trauma. Prompt diagnosis and appropriate management resulted in favourable outcome for the fracture, though ...

OBJECTIVE To understand the potential fracture mechanism of sternal wires, we collected extracted stainless steel sternal wires from patients with sternal dehiscence following open-heart operations. Surface alterations and fractured ends of sternal wires were inspected and analyzed. METHODS Eight fractured and 12 non-fractured wires extracted from five patients (closure method: figure-of-eigh...

BACKGROUND Stainless steel wiring remains the most popular technique for primary sternal closure. Recently, a multifilament cable wiring system (Pioneer Surgical Technology Inc., Marquette, MI, USA) was introduced for sternal closure and has gained wide acceptance due to its superior resistance to tension. We aimed to compare conventional steel wiring to multifilament cable fixation for sternal...

The purpose of this study was to determine and compare the maximum concentration (C(max)) and time to maximum concentration (T(max)) of epinephrine administered via tibial intraosseous (IO), sternal IO, and intravenous (i.v.) routes in a porcine model of cardiac arrest during cardiopulmonary resuscitation. Five pigs each were randomly assigned to 3 groups: tibial IO, sternal IO, and i.v. Cardia...

OBJECTIVES Various methods for sternal approximation have been described previously. Some patients undergoing these procedures are at risk for sternal dehiscence and mediastinitis. We used a different method, with a suture anchor system, for median sternotomy closure as an alternate technique in patients with a high risk of postoperative sternal dehiscence and sternal nonunion. MATERIAL AND M...

An imaging study is needed that can detect sternal wound infections and distinguish between superficial and deep sternal wound infection when a clinical diagnosis is uncertain and a decision regarding surgical intervention must be made. We retrospectively reviewed the 99mTc-leukocyte scans of 29 patients referred to rule out sternal wound infection. The presence or absence of deep or superficia...