FAILURE ANALYSIS OF STERNOTOMY

Abstract eng:
Median sternotomy is a surgical procedure allowing direct access to the hearth via sternum dissection. The post-operative complications – infection and dehiscence – are associated with high morbidity and mortality rate. Out of the available techniques used to re-approximate the two sternum halves the wiring technique is preferred. This approach has specific problems demonstrated by the rupture of the wire or cutting through the bone. There is a limited knowledge about the biomechanical chest behaviour and the interaction at the interface between bone and sutures. These data are very difficult if not impossible to obtain via direct measurement ‘in vivo’ and even experimentally ‘in vitro’, due to complexity of the whole system and number of not well defined parameters that might play important role in the process. This paper will try to bring more information, by means of computational simulation, about the bone response to the presented suturing technique, the magnitude of stresses developed within the sutures, analysis of the relative displacement of the two halves, their behaviour, and the possibility of bone failure at the bone-wire interface.

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