Turnover procedure.

Sternal turnover can be considered an orthotopic bone transplantation in reverse position. It yields immediate stability of the chest and good cosmetic results. Procedures using "pedicled plastrons" (rectal muscles, internal mammary arteries) have been reported; a large series of 300 cases, however, shows satisfying results with free grafts. Technetium-99m isotope studies yielded visualization of the plastron 1 year after sternal turnover. After redo-operations, histopathologic studies gave nearly normal sternal bone marrow findings.