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J Thorac Cardiovasc Surg 2009;138:1248-1250
© 2009 The American Association for Thoracic Surgery

Brief Technique Report

Use of moldable titanium bars and rib clips for total sternal replacement: A new composite technique

^a Thoracic Surgery Unit, University Hospital Careggi, Florence, Italy
^b Orthopedic Oncology, University Hospital Careggi, Florence, Italy
^c Plastic Surgery, University Hospital Careggi, Florence, Italy
^d Anesthesiology Unit, University Hospital Careggi, Florence, Italy

Received for publication July 14, 2008; revisions received September 4, 2008; accepted for publication September 14, 2008.

^_* Address for reprints: Alessandro Gonfiotti, MD, Thoracic Surgery Unit, Azienda Ospedaliero–Universitaria Careggi, Viale Pieraccini n17, 50100, Firenze, Italy. (Email: agonfiotti@alice.it).

The first 20% of the full text of this article appears below.

	Introduction

 
After a total sternectomy, a rigid prosthetic replacement is usually recommended to protect the lungs, heart, and main vessels and to prevent paradoxical respiration.¹ The most common system used for rigid reconstruction of the sternum is methyl methacrylate, which is difficult to handle and mold into the correct shape.² We describe a rigid sternal reconstruction after total sternectomy using a new system with moldable titanium bars and rib clips.

	Clinical Summary

 
A 65-year-old woman was admitted to our unit for a large and palpable chondrosarcoma of the sternum. The computed tomogram confirmed a lesion occupying the whole sternal body along with invasion of the manubrium (Figure 1, A ), and a positron emission tomogram revealed a strong accumulation in the lesion, without accumulation elsewhere in the body. On this basis we performed a total sternectomy, including the entire sternum together with the previous site of biopsy, costochondral arches, and internal third of clavicles, with healthy margins of at least 3 cm (Figure 1, B). After resection, . . . [Full Text of this Article]

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				A. Gonfiotti, P. F. Santini, D. Campanacci, M. Innocenti, S. Ferrarello, A. Caldarella, and A. Janni Malignant primary chest-wall tumours: techniques of reconstruction and survival Eur J Cardiothorac Surg, July 1, 2010; 38(1): 39 - 45. [Abstract] [Full Text] [PDF]