Sternal nonunion on bone scintigraphy: a case report

Document Type : Case Report

Authors

1 Golestan Research Center of Gastroenterology and Hepatology (GRCGH), Golestan University of Medical Sciences (GUOMS), Gorgan, Iran

2 The Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran

3 Department of Surgery (division of cardiac surgery), Bushehr Medical Center Hospital, Bushehr University of Medical Sciences, Bushehr, Iran

Abstract

Sternal non-union is a severe complication of sternotomy closure following open heart surgeries. Healing problems typically occur in 0.3% to 5% of patients. Technetium-99m methylene diphosphonate (99mTc-MDP) bone scintigraphy has been used to assess bone nonunion to predict the healing response for proper management.

 In this report, we present the case of a marked sternal nonunion following coronary artery bypass graft (CABG), using radionuclide bone scintigraphy.

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Satta J, Lahtinen J, Räisänen L, Salmela E, Juvonen T. Options for the management of poststernotomy mediastinitis. Scand Cardiovasc J. 1998;32(1):29-32.
El Oakley RM, Wright JE. Postoperative mediastinitis: classification and management. Ann Thorac Surg. 1996 Mar;61(3):1030-6.
Stoney WS, Alford WC Jr, Burrus GR, Frist RA, Thomas CS Jr. Median sternotomy dehiscence. Ann Thorac Surg. 1978 Nov;26(5):421-6.
Hendrickson SC, Koger KE, Morea CJ, Aponte RL, Smith PK, Levin LS. Sternal plating for the treatment of sternal nonunion. Ann Thorac Surg. 1996 Aug;62(2):512-8.
Günalp B, Ozgüven M, Oztürk E, Ercenk B, Bayhan H. Role of bone scanning in the management of non-united fractures: a clinical study. Eur J Nucl Med. 1992;19(10):845-7.
Desai A, Alavi A, Dalinka M, Brighton C, Esterhai J. Role of bone scintigraphy in the evaluation and treatment of nonunited fractures: concise communication. J Nucl Med. 1980 Oct;21(10):931-4.
Barros JW, Barbieri CH, Fernandes CD. Scintigraphic evaluation of tibial shaft fracture healing. Injury. 2000 Jan;31(1):51-4.
Li AE, Fishman EK. Evaluation of complications after sternotomy using single- and multidetector CT with three-dimensional volume rendering. AJR Am J Roentgenol. 2003 Oct;181(4):1065-70.
Serry C, Bleck PC, Javid H, Hunter JA, Goldin MD, DeLaria GA, Najafi H. Sternal wound complications. Management and results. J Thorac Cardiovasc Surg. 1980 Dec;80(6):861-7.
Ståhle E, Tammelin A, Bergström R, Hambreus A, Nyström SO, Hansson HE. Sternal wound complications--incidence, microbiology and risk factors. Eur J Cardiothorac Surg. 1997 Jun;11(6):1146-53.
Wu LC, Renucci JD, Song DH. Sternal nonunion: a review of current treatments and a new method of rigid fixation. Ann Plast Surg. 2005 Jan;54(1):55-8.
Eftekhari M, Assadi M, Fard-Esfahani A, Beiki D, Fallahi B. Dystrophic calcinosis cutis and SLE; the bone scan pattern. Iran J Nucl Med. 2004;12(2):1-4.
Chepla KJ, Salgado CJ, Tang CJ, Mardini S, Evans KK. Late complications of chest wall reconstruction: management of painful sternal nonunion. Semin Plast Surg. 2011 Feb;25(1):98-106.