Sternum repair after surgery

[Glboater]

Hello,

I am a 6'5", 290# male that is 18 months post quad CABG. I felt great after surgery, I was up walking that afternoon and went home in three days. I started walking immediately but about a week or so into it I felt my chest / sternum was moving around to much. At least to much for my liking. Both my surgeon and cardiologist says this is normal. I continued walking and thinking the movement got worse. At four weeks I went back in and the surgeon stood me up against the wall and pushed dead in the middle of the setrnum ans started going down. At the base he stood back with a look I never want to see again. He immediately sent me in for a MRI and concluded that I had broken the wires holding the sternum together. THere was so much movement that the fuse process never got going. Back into surgery I went to re-wire. This time he used a cross pattern and around and through. OK, so my rehab was pushed back 6 weeks, not so horrible in the whole scheme of things. BYW, I had been told that the 2nd surgery was nothing compared to the first. They were right.

So, now you have the background. The issue is that I still feel movement and all the Dr's at this point say I have to live with it. No one suggests going back in a third time. So my question is:
1. is anyone else in this situation with a sternum that will not fuse.
2. How are they handling it.
3. The Dr's tell me that I will feel pain and stop the activity (lifting and such) before there are any issues with the sternum, so in other words don't worry.
4. Does it eventually fude a bit more and more?

Would like to hear what anyone has to say.

Thanks for Listening

 

[Greg a]

First and foremost WECLCOME TO THE FAMILY I have no sternum but also we have had discussions here about

-pectoral flaps
=Kryptonite glue
-Talons
-stainless plates backing the sternum

 

[Glboater]

Thanks for the Welcome !!!

I've also read about a product called STERNA BAND, anyone have that or heard of it??

 

[bdryer]

Wow the broken sternum wire thing really worries me as I am rehabbing. I'm two weeks post op. My research found the sternum wire to be 22 gage or .025 in Dia. I have a lot of experience with .020 and .032 Dia lock wire in aviation. .020 can easily break. We use this wire predominantly for safetying of multi connectors or cannon plugs. .032 is very strong. I wish they used this Dia.

 

[Lynlw]

Hi, I'm sorry you are still going thru problems. When you stay you can still feel it moving, do you mean when you are just doing norml things it moves, or there is a 'click" if you push on it? Do you have any idea how all the wires broke? My son had problem with his sternum after his 5th OHS, but he had an infection, he had surgery to clean that up and when they closed him they had to leave out all the wires (except the very top one, so they also did a muscle flap. he healed well, but has a "click" if they press on it.
I'm curious are you a diabetic? or any of the conditions that increase the risk of a "non union" like Osteoporosis ?

I don't know where you had your surgery, but If there is alot of movement and it still hasn't fused have you thought about getting a 2nd opinion?

 

[Jkm7]

Welcome to VR.org. Happy you found us but sorry for all you have gone through.

I would definitely go to a major heart center for another opinion.

 

[Bryan B]

I can't really help you with the sternum not fusing but I did have sternum problems after my surgery. They could never find the problem (said the wires were fine) but I had continuous pain from them. The pain started when I was doing an arm/chest exercise with a thing that looks like bike pedals while in cardiac rehab. They finally removed the wires after 6 months and the pain was gone. My surgeon said he still didn't see any problems when he got in there. I just had a 2nd heart surgery and asked my surgeon if he could use talons (fairly new product you may want to research) or Kryptonite glue which is still experimental (might want to research that too). He said no that he only uses wires because that is what he has had the most success with. He also used staples on my incision and I asked if he could use glue (on the outside). Again he said no because he only uses what he has had the most success with. My incision, while ugly, has healed wonderfully with no issues. I just hope my body accepts the wires better this time.

It isn't all that uncommon for patients to have problems with sternum dissonance after surgery. I did some googling and it seems the Kryptonite glue (maybe reinforced with wires?) has been used to repair patient's sternums that will not fuse. I would do some research and ask your doctors about alternative treatment options armed with the new information you have gathered. If you are not happy with them telling you to "live with it" I would look for someone else for another opinion. They may be more willing to find a solution to your problem.

 

[Mentu]

My sternum was secured with Sternal Talons after my valve replacement.

View attachment 8928

Talons were originally designed to help solve problems such as your own and may provide an alternate solution for you. Essentially these are a set of clamps that pull the two halves of the sternum together then lock in place. If you would like to read more about them, the website for the brocheur is:

http://www.rapidsternalclosure.com/medical/Sternal_Fixation_-_Sternal_Talon.pdf

The main website is:

http://www.rapidsternalclosure.com/medical/

Let me know if you would like more information.

Larry

 

[Protimenow]

Mentu:

Just curious -- do those talons show through the skin? (After I had my OHS, I took my daughter to a father-daughter dinner, and a few other dads noticed my still healig scar. I embarrassed my daughter when I was one of a group of dads comparing sternal scars. I think it would have been even more interesting (and embarrassing to my daughter), if I drew attention to the talons sitting under the skin).

 

[Mentu]

Not only can one not see the Talons but I can only slightly feel the bottom one when I bend backwards over the edge of my bed. We have a sense that our sternum is just below the skin but there is actually about an inch of muscle and such between the bone and the skin above it. Even immediately after surgery, I had no sense that they were there. One side effect of the Talons is that there is almost no chest pain at the incision site after surgery. My left shoulder ached and some of my ribs hurt but not the center of my chest. I could sneeze and cough without difficulty. I was stiff getting in and out of bed but it didn't hurt to do so. All things considered, that was an unexpected but pretty nice side effect. I almost felt that I had not earned my bear.
View attachment 8929

Larry
Tulsa, OK

 

[Protimenow]

Wow. I hope to never need my sternum cracked again during my lifetime, but talons sure sound like an interesting development and one to discuss with my doctor (should I ever need OHS again).

 

[bdryer]

Kryptonite glue was developed in my home hospital, being the Calgary Foothills, by Dr Paul Fedak. Dr Kidd did my surgery. Unfortunately even though I requested the application of the glue, I was rejected as the glue is in clinical studies. It will be several years before the glue is approved as common practice.

I spoke with Dr Fedak over my time in the hospital. He has deep compassion for patients of OHS and wishes that the glue was approved. The glue sets up in 3 hours and the bone knits through the glue. It is made up of calcium carbonate and castor oil.

Folks in the waiting room may in the very near future have the glue applied to the bone incision.

Anyone who is scheduled for OHS presently, would be advised to request the Kryptonite glue as your hospital may be involved in the world wide clinical study.

 

[bdryer]

Glboater

Wow you are a big guy. Me I'm 155 lbs and 5'7". Big difference between me compared to you inadvertently using your arms or elbows, exerting a force against .025 wire. I'm certain you had great difficulty getting in and out of bed. In an unaware moment you may have used your arms or elbows and snapped the wires while getting in or out of bed in a groggy state. Glad they got you fixed.

 

[Glboater]

Actually I had no isses getting in or out of bed. The only issue I had post op was the coughing and this is where I think I may have broken the wires. My surgeon told me that an 85 YO woman had an easier recovery than I would. Becasue of my size it's the volume in the chest that was so tough. The coughing did me in. That was absolutely the worst part for me.

I'm seeing my surgeon later this week and while I have no desire to go under again, I want him to take a look and of course will consult with him on the Sternal Talons and Kryptonite glue

Thanks

 

[Michellemar]

My take on possible help for bone healing

My take on possible help for bone healing

Hi, I haven't had my surgery yet (it's on April19-under 2wks from now)... But being 1970 Hodgkin's survivor...with the mantle treatment radiation, sternal (about everything!) healing for me will not be the average.... As radiation creates alot of fibrosis, and not alot of healing blood supply to that! The following is meant ONLY as adjunctive ideas, for heaven's sakes listen to your doctor!!!! They know why they say and do what they do!!!!!!! This is info just for speculation, if you think any of the subjects might help it's YOUR DOCTOR who will yay or nay it, don't "go off" on your own!!!! These Drs... how many pts???? have literally held your heart in their hands,awesome or what.
What I thought might help you, is several things normal Dr.s are too busy for...(like saving our lives). I studied Oriental medicine, and had acupuncture for years. My osteo surgeon said he'd seen it in action in China and was very impressed, wished it could anesthetize deep enough for hip replacements(can't) but what it has a genius for is connecting one part of the body to the other part it was severed from. It is routine for nerve regrowth, reconnection as in trigeminal neuralgia, and the needles also are great for reconnecting bones that just dont want to reconnect. I don't know which end of the country you're at, but there are more Drs of Oriental Medjcine around all the time... Google it for your area... They also are on medical
insurance plans....the other, way less miraculous but good are health food stores, with a knowledgeable person in the herbs, vitamins and supplements area, who would know some of our early American pharmacopeia used before the advent of inorganic stuff... And herbs work albeit subtly. For my bones (radiated) my Dr. recommended strontium (sounds weird,huh?) and horsetail..that stuff that grows in ponds, for the silica. Hope this gives you a bit of sense that you CAN do SOMEthing .... Even if a little out-of-the-box! Here's to healthier... All of us! Michelle

 

[Bryan B]

Hi, I haven't had my surgery yet (it's on April19-under 2wks from now)... But being 1970 Hodgkin's survivor...with the mantle treatment radiation, sternal (about everything!) healing for me will not be the average.... As radiation creates alot of fibrosis, and not alot of healing blood supply to that!
What I thought might help you, is several things normal Dr.s are too busy for... I studied Oriental medicine, and had acupuncture for years. My osteo surgeon said he'd seen it in action in China and was very impressed, wished it could anesthetize deep enough for hip replacements(can't) but what it has a genius for is connecting one part of the body to the other part it was severed from. It is routine for nerve regrowth, reconnection as in trigeminal neuralgia, and the needles also are great for reconnecting bones that just dont want to reconnect. I don't know which end of the country you're at, but there are more Drs of Oriental Medjcine around all the time... Google it for your area... They also are on medical
insurance plans....the other, way less miraculous but good are health food stores, with a knowledgeable person in the herbs, vitamins and supplements area, who would know some of our early American pharmacopeia used before the advent of inorganic stuff... And herbs work albeit subtly. For my bones (radiated) my Dr. recommended strontium (sounds weird,huh?) and horsetail..that stuff that grows in ponds, for the silica. Hope this gives you a bit of sense that you CAN do SOMEthing .... Even if a little out-of-the-box! Here's to healthier... All of us! Michelle

OK here I am again lol. Please don't take this personally Michelle but I want to give my opinion on your post. In my personal opinion, once a sternum has been sawed in half and sternal dissonance occurs...acupuncture, herbs, vitamins, and supplements are not going to help. However if I am wrong that would be a good thing.

 

[Michellemar]

Hi Bryan B... Thanks for your post... I looked up sternal dissonance everywhere but couldn't find the term. I'd go for the Talons... But don't know what sternal dissonance is.... I know even western medicine uses elec stim to connect long bones in trouble healing... More info would be helpful (?). Thanks Michelle

 

[Greg a]

Hi Bryan B... Thanks for your post... I looked up sternal dissonance everywhere but couldn't find the term. I'd go for the Talons... But don't know what sternal dissonance is.... I know even western medicine uses elec stim to connect long bones in trouble healing... More info would be helpful (?). Thanks Michelle

dis·so·nancenoun /ˈdisənəns/
dissonances, plural

Lack of harmony among musical notes
- an unusual degree of dissonance for such choral styles
- the harsh dissonances give a sound which is quite untypical of the Renaissance


A tension or clash resulting from the combination of two disharmonious or unsuitable elements
- dissonance between campaign rhetoric and personal behavior

FYI I think Bryan was trying to convey that the ribs and sternum may not be harmonius in rejoining and require the healing of bone and conective tissue

In my case the sternum was totaly removed and ribs the rounded and a pectoral flap procedure done with a little "nip/tuck" of diaphram muiscle

 

[Lynlw]

Hi Bryan B... Thanks for your post... I looked up sternal dissonance everywhere but couldn't find the term. I'd go for the Talons... But don't know what sternal dissonance is.... I know even western medicine uses elec stim to connect long bones in trouble healing... More info would be helpful (?). Thanks Michelle

I believe he was talking about Sternal dehiscence

 

[Michellemar]

Lyn, absolutely 10-4 on that one. Thank you it is Sternal dehiscence. For anyone wanting to understand sternal healing, google sternal dehiscence... You'll hit 10 letter word sites, but they are eye-openers as to how at least YOU can help-like quit twisting and doing stuff before it's healed... Bones=immobility ... They just can't put a cast on your chest.!! If you google bone-healing Acupuncture, again more 10 word sites... The best kinda are Japanese or oriental because translating oriental healing medical philosophy into western can get literal studies... Or. Med. Treats ALL body systems as integrated, but way less linearly in thinking as western med philos ...5000 years and the Chinese haven't dumped it for western, though they certainly use both. Bryan, you really threw me because as a Chorale singer, I sure know dissonance, and I was trying to visualize..as both halves of body meet in center, COULD the mediastinum being almost a mirror image both sides stop the body's urge to reconnect....(??)... (thinking Chinese) But then realized... We are organic so we don't mirror completely. Thank the Lord, Lyn, you redirected! The words can sound so much alike...Well, I had mediastinal radiation, which means blood supply, all the living goodies in "younger" mediastinums will be a bit less for me....so if I get the buzz saw... This thread entirely will be helpful really possibly unfortunately for me!!!! Thanks you guys, heal up !!! If you're breathing, your body still wants to so keep doing your outtasight research...! Thanks, guys. Michelle