Chest Wall Stabilization
What is Sternal Nonunion and Instability?
At the conclusion of heart surgery, the heart surgeon wires the breastbone back together to facilitate complete healing. There is a population of patients, two to three percent, whose breastbones heal improperly after surgery. This is referred to as sternal nonunion and instability, and leaves the patient with an unstable chest wall that can be painful or uncomfortable. Chest wall stabilization addresses this problem.
What are the symptoms of Sternal Nonunion and Instability?
Following heart surgery, the improper healing breastbone may cause pain, clicking, popping or grinding in the breastbone. The chest may feel unstable, or that each side of the rib cage moves separately when the person breathes. Understandably, the anxiety over these symptoms can lead a person to various doctors and perhaps even hospitalization.
What is Chest Wall Stabilization?
If a patient is experiencing sternal nonunion and instability, the options available are either to do nothing and live with it, or have the bone stabilized (repaired). Reconstructive plastic surgeons are specially trained experts in the surgical technique to correct this problem. The plastic surgeon uses titanium metal plates to bridge the fractured bone and give it the much-needed stability it lacks. Chest wall stabilization is much less invasive than the heart surgery from which the problem originated. In fact, the plastic surgeon does not enter the chest cavity at all to repair the bone. The procedure is performed just under the skin and muscle layer, on top of the ribs and breastbone. This surgery, with the aforementioned hardware, has been shown to result in low recurrence and complication rates. In follow-up evaluations, studies have found the patient’s symptoms have resolved.
What are the results of Chest Wall Stabilization?
In a review of treatments for sternal nonunion and instability1, all subjects who underwent the type of procedure described here experienced a successful outcome. Pain completely resolved in all patients. All wounds healed to completion, and there was no incidence of subsequent infection.
(1Annals of Plastic Surgery, Jan. 2005)
How does a person know if he/she is a candidate for this procedure?
Anyone who suspects he/she may be suffering from sternal nonunion and instability should make an appointment with Dr. Michael Rose for a consultation. He will assess the chest wall dynamics and provide a diagnosis and possible treatment options for the candidate.