In cardiac surgery, stable fixation of the sternum is critical for patients' postoperative recovery. As a specially designed medical device, the core function of the sternal fixation system is to ensure the stability of the sternum during surgery and promote the recovery of thoracic continuity and stability after surgery, thus laying a solid foundation for patients' smooth rehabilitation. This article will deeply explore the common types of sternal fixation systems, their application scenarios, and their important value in improving surgical outcomes and patient prognosis.

 

 

 

Methods of sternal fixation have continuously advanced with the development of medical technology. Traditionally, wire fixation has been widely used in clinical practice due to its cost-effectiveness, easy availability, good plasticity, and simple operation. However, despite these advantages, wire fixation may put some patients at risk of postoperative complications, which has driven the exploration and development of more advanced fixation methods.

 

In recent years, sternal cerclage bands, as an emerging fixation method, have gradually gained popularity. Compared with traditional wires, sternal cerclage bands have shown more reliable effects in reducing postoperative complications, providing clinicians with a better option, especially in cases pursuing better postoperative recovery quality.

 

 

 

    The titanium sternal fixation plate system is usually composed of thin and lightweight plates, which are designed to span the sternotomy line and be fixed on both sides of the sternal midline through screws. Its design concept is highly aligned with human anatomy, and the shape of the plate matches the natural geometry of the sternum, aiming to provide superior fixation effect and structural stability, thereby effectively distributing stress and promoting healing.

 

    The sternal fixation clip is an internal fixation device designed for longitudinal sternotomy or reduction of sternal fractures. Its main goal is to provide structurally reasonable and reliably stable support, create an environment conducive to the revascularization of sternal bone and the natural growth and recovery of bone, and accelerate the bone healing process.

 

    The sternal compression plate is a medical device integrating the concept of minimally invasive technology. It is suitable for fixing and stabilizing the chest wall, and can provide effective fixation support for both normal bone and ribs with osteoporosis, helping to reduce surgical trauma and promote recovery.

 

 

 

In the reduction and fixation after median sternotomy, the intercostal fixation method is an important technical means. The anatomical structure of the ribs determines that fixation operations can be performed in the 1st to 5th intercostal spaces, while the 6th to 7th intercostal spaces are usually fused into one. Based on this anatomical feature, when the intercostal fixation method is fully adopted, a single-stitch fixation can theoretically fix up to 5 stitches at most, and the figure-of-8 fixation method can theoretically fix up to 4 stitches at most. These technical details are crucial for surgical planning.

 

For cardiac surgery in patients at high risk of sternal dehiscence, selecting an appropriate sternal fixation mode is particularly critical. Clinical studies often explore the therapeutic effects and influencing factors of different fixation modes, such as traditional wire fixation, titanium plate fixation, and sternal plate fixation. Through comparison and analysis of these modes, more individualized, safe and effective fixation schemes can be formulated for high-risk patients.

 

In addition, some composite fixation technologies have also been applied in practice, such as the 360-degree sternal fixation technology combining sternal plates with wire cerclage. Such technologies usually use plates of specific shapes (such as H-shaped plates), and through the synergistic effect of screws and wires, the two halves of the sternum are closed more tightly, further enhancing the stability of fixation and providing stronger support for complex cases.

 

 

 

The sternal fixation system plays an indispensable role in cardiac surgery, and its selection and application are directly related to patients' surgical outcomes and postoperative recovery. From traditional wires to emerging cerclage bands, to various exquisitely designed fixation plates, fixation clips and compression plates, as well as composite fixation technologies for special situations, sternal fixation systems are developing in a safer, more effective and more ergonomic direction.

 

Understanding the characteristics, applicable scenarios of different sternal fixation systems and their application strategies in high-risk patients is of great significance for cardiac surgeons to optimize surgical plans, reduce complication risks and improve patients' quality of life. With the continuous innovation of medical materials and technologies, sternal fixation systems will continue to contribute to the progress of the field of cardiac surgery.