Sternal plating to prevent malunion of transverse sternotomy in lung transplantation.

Sternal malunion can be a significant cause of morbidity in double-lung transplantation when it is performed through a thoracosternotomy or clamshell incision. Some patients experience increased pain with malunion and have delayed or decreased functional recovery. We propose a method of sternal plating to decrease the incidence of sternal malunion encountered with this incision. The transverse sternotomy can be rigidly fixed with two titanium interlocking plates during chest closure, a procedure that offers the potential for timely and consistent union of the sternum. The interlocking plate configuration also affords a unique quality to this closure; a pin securing the two plates can be quickly released allowing expedient access to mediastinal structures if emergent re-entry is necessary.