• Journal of Chest Surgery
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• v.50 no.6
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• pp.460-462
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• 2017

We herein present the unique case of a 68-year-old male diabetic patient who developed sterile necrosis of the sternum 1 month after myocardial revascularization with the use of bilateral internal thoracic artery grafts. The sternum had been closed by the bilateral Robicsek wiring technique. The sternum was removed, and bilateral pectoralis major flaps were used to cover the defect. The patient had an uneventful recovery.

• Journal of Chest Surgery
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• v.27 no.8
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• pp.708-709
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• 1994

Tuberculosis infection of sternum is extremely rare. The most common cause of sternal osteomyelitis is infection of a median sternotomy incision, employed for most cardiac operation. If a wound infection of this regeon becomes apparent, the wound should be opened wide to allow adequate drainage. Frequent irrigation and debridement are necessary to avoid extension of the infection into the bone. We have experienced a 16 years old female who has been operated upon due to ASD, was infected with tuberculosis in sternum. Our team have treated her for tuberculous osteomyelitis on sternum with curettage and drainage.

• Archives of Plastic Surgery
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• v.46 no.5
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• pp.470-474
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• 2019

Congenital absent sternum is a rare birth defect that requires early intervention for optimal long-term outcomes. Descriptions of the repair of absent sternum are limited to case reports, and no preferred method for management has been described. Herein, we describe the use of porcine acellular dermal matrix to reconstruct the sternum of an infant with sternal infection following attempted repair using synthetic mesh. The patient was a full-term male with trisomy 21, agenesis of corpus callosum, ventricular septal defect, patent ductus arteriosus, right-sided aortic arch, and congenital absence of sternum with no sternal bars. Following removal of the infected synthetic mesh, negative pressure wound therapy with instillation was used to manage the open wound and provide direct antibiotic therapy. When blood C-reactive protein levels declined to ${\leq}2mg/L$, the sternum was reconstructed using porcine acellular dermal matrix. At 21 months postoperative, the patient demonstrated no respiratory issues. Physical examination and computed tomography imaging identified good approximation of the clavicular heads and sternal cleft and forward curvature of the ribs. This case illustrates the benefits of negative pressure wound therapy and acellular dermal matrix for the reconstruction of absent sternum in the context of infected sternal surgical site previously repaired with synthetic mesh.

• Journal of Chest Surgery
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• v.7 no.1
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• pp.67-72
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• 1974

This is a case report of total sternal resection and successful reconstruction of the sternum applying Tantalum plate in multiple myeloma. The patient was a 57 year old male with a tumor located on the middle sternum invading the manubrium and the body of the sternum developing symptoms after a contusion of the anterior sternum. The sternum resected with left and right. from first to sixth costochondral cartilages, and then Tantalum plate was fixed to the all fragments of the ribs with wire sutures. After reconstruction of the sternum applying Tantalum plate, the patient has had good breathing movements of the chest wall and also maintenance of respiratory function was satisfactory. Histopathologically, the tumor was consisted of a tissue of plasma cells, which was identical to multiple myeloma. Postoperative chemotherapy with Endoxan for multiple myeloma was administered. No recurrent symptoms of multiple myeloma could be observed during one year follow up period.

• Journal of Chest Surgery
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• v.12 no.3
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• pp.151-158
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• 1979

This is a report of 3 cases of tumors, which primarily originated from ribs and the sternum. In the first case of multiple myeloma, the patient was 67 year old male with a tumor located on the middle sternum invading the manubrium and the body of the sternum manifesting symptoms after a contusion of the anterior sternum. The sternum was entirely resected and was replaced by tantalum plate to reconstruct the defective chest wall in order to prevent the paradoxical movement during respiration. In the second case of osteogenic sarcoma, the patient was 43 year old male with a tumor located on the costochondral junction of the left 5th rib for 6 months. The left 5th rib was resected between the middle part and sternochondral junction of it including tumor and adjacent soft tissues. In the third case of chondrosarcoma, the patient was 36 year old male with a tumor located near the posterior angles of the right 7th and 8th ribs manifesting back pain on the area where the tumor was located. Resection of right lower lobe was performed since direct invasion of tumor was seen in the superior segment of right lower lobe. This was followed by the resection of both 7th and 8th ribs at the area between the costovertebral junction and the portion 10 em apart from the tumor including the tumor and intercostal soft tissues. Diagnoses of 3 cases of tumors described above were confirmed by histopathologic examination postoperatively. The postoperative courses were uneventful.

• Journal of Chest Surgery
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• v.9 no.2
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• pp.143-147
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• 1976

A case of congenital funnel chest which was observed in 6 year old male was reported. The patient represented clinical status of depression of lower sternum, recurrent upper respiratory tract infection, and slight exertional dyspnea. The treatment was carried out by "turnover" method, and it was easy to do viable on sternum, costal cartilage, and intercostal muscles. And it is fit to reimplantation by free autograft when repair was indicated. The plane of the manubrium, an acute hump on the sternum, and asymmetry constitute limiting factors in the cosmetic results.

• Journal of Chest Surgery
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• v.23 no.4
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• pp.820-824
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• 1990

A very early and effective technique of sternal closure by plastic plates was successfully applied to a 7-months-old infant of tetralogy of Fallot in whom the standard closure of sternum was not possible due to massive generalized edema after cardiopulmonary bypass for total correction. This technique provides not only solid but also permanent closure of the sternum so that any early reoperation for closure of sternum and its accompanying risk of infection in many other known methods can be avoided.

• Journal of Chest Surgery
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• v.46 no.6
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• pp.482-485
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• 2013

Plasmacytoma is a plasma cell neoplasm that locally infiltrates a bone or spreads to extramedullary areas. A new World Health Organization criterion defines solitary plasmacytoma of bone as a localized bone tumor consisting of plasma cells identical to those seen in plasma cell myeloma, which is manifested as a solitary osteolytic lesion in a radiological evaluation. Primary tumors of the sternum are generally malignant, and solitary plasmacytomas of the sternum are very rare tumors. We present herein the case of a patient who had a primary sternal tumor with solitary plasmacytoma and no evidence of multiple myeloma.

• Journal of Chest Surgery
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• v.28 no.11
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• pp.977-982
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• 1995

Early repair of complex congenital heart malformation may lead to life-threatening respiratory and hemodynamic embarrassment on sternal closure. We performed delayed sternal closure in nine neonates to avoid a fatal outcome in these situations. Primary elective open sternum was used in 8 [66.7% and primary sternal closure in 4 [33.3% of the 12 patients studied. one patient with primary sternal closure underwent delayed sternal reopening in the intensive care unit. Of the 9 patients with open sternum, 2 patients died of low cardiac output and acute renal failure respectively before delayed sternal closure. 7 patients could undergo delayed sternal closures 3 days after initial operation. The mean age at open cardiac procedure was 14.3 days [range 3 to 30 and mean preoperative weight was 3.4kg [range 2.8 to 4.1 . The aortic cross-clamping time was longer in the group with open sternum than the group with closed sternum [p=0.042 . There was no morbidity and mortality related to delayed sternal closure. Given the low morbidity and potential benifits, this technique should be used in neonates after open heart procedures when postoperative mediastinal compression produces frank low cardiac output or respiratoy compromise during a trial of sternal closure.

• Journal of Chest Surgery
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• v.26 no.10
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• pp.787-790
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• 1993

The purpose of this study is to analyze the early results by the operative methods in 36 patients with pectus excavatum during the period August 1989 to August 1993. We underwent Ravitch`s operation in 15 patients [mean age : 11.0], which consists of subperichondral resection of all deformed cartilages, anterior wedge osteotomy and fixation in place with wire sutures of the sternum, and sternal eversion operation in 21 patients[mean age : 5.3], which consists of en-bloc resection of deformed sternum and cartilages, tailoring of the costal cartilages and shaping of the sternum and fixation of sternum and cartilages. Early results were satisfactory in 93% [Excellent 93%] for Ravitch`s operations and in 100% [Excellent 90% and Good 10%] for sternal eversion operations. But late results by sternal growth will be necessary longer follow-up.