Trans-sternal titanium fixation bars: an initial experience with 28 patients.

A clinical experience is described with the use of titanium trans-sternal fixation bars to achieve either primary or secondary sternal closure and stability using the principle of rigid fixation in high-risk and wound salvage sternotomy patients. The purpose of rigid fixation in those situations is not only to achieve rapid strong bone healing, but to improve respiratory function by restoring compliance and thoracic support for the lungs, especially in patients with severe pulmonary compromise. The system may be difficult and expensive to apply, but the positive results in most if not all the initial 28 patients appear to justify its use. Our earlier article (Schulman NH, Subramanian V. Plast Reconstr Surg. 2004;114:44) categorized the wounds, and by use of an outlined algorithm, it outlined the desired treatment. This report deals primarily with the use and purpose of rigid fixation of sternotomy wounds.