Can My Sternal Non-Union Be Fixed?
Q: Dr. Eppley, I had a single cardio bypass done last fall. My doctors failed to notice that my sternum was not healing together. The doctor who performed the surgery knew ahead of time that I have EDS with sublexes of all joints, discs and sternum. Because of the surgery I am still being told I can only move as if the surgery was just done, that the sterna wires were holding me together. The sternum has shifted and even if it does mend together eventually it is still causing more dislocations of the collar bones. I have problems with collapsing lungs from the inflammation because of the movement all the time. What are my options for repair? Living like this I am unable to breathe or move without pain. This is not my idea of living. Please respond as I am getting very depressed.
A: While this is an issue for your cardiothoracic surgeon to determine, it appears that your primary problem may be a sternal non-union and instability. If the sternum has not healed and become stable at more than nine months after surgery, then it is not going to be. While wires are a common method of sternal fixation, they may not be sufficient in some cases. One option to consider is that of sternal plate rigid fixation. Removal of the wires, interpositional allogeneic bone grafting with PRP (platelet-rich plasma) and compression and fixation of the sternal edges by plates and screws designed exactly for this use is the only treatment option at this point. Its use depends on how good the remaining sternal bone is, of which only your cardiac surgeon knows. It may well be that he chose wires exactly because the bone quality was inadequate. There is also the issue of whether having EDS (Ehlers Danlos Syndrome) leads to impaired bony healing and non-unions given the underlying genetic disorder of connective tissue and collagen formation. Your sternal non-union may have been unavoidable.
Dr. Barry Eppley
A detailed description and pictures of your concerns allows for the most informed response.