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Rigid Sternal Fixation & Recovery

Content Type: Protocols | Provider

Created: June 28, 2021
Contributor: ERAS Cardiac Collaborative Network
Editors: Cheryl Crisafi MSN RN CNL • Amanda Rea DNP CRNP AGACNP-BC CCRN CMC CSC E-AEC • Gina McConnell RN BSN CCRN • Shannon Crotwell RN BSN CCRN • Alexander Gregory MD FRCPC

Summary

Rigid sternal fixation offers critical benefits for patients recovering from cardiac surgery. By improving the stability of the sternum, this technique can reduce complications, support respiratory function, enhance pain control, and improve early mobility — all contributing to better patient outcomes and faster recovery.

Sternal complications such as dehiscence and mediastinitis can significantly delay recovery, increase pain, and elevate healthcare costs. Rigid fixation is a structural approach to mitigate these risks and enhance healing at the surgical site.

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AI Assistance Statement

This summary was developed with assistance from artificial intelligence and reviewed, edited, and approved by the listed editor(s). Reference: OpenAI (2025). ChatGPT (November version) [Large language model]. 
https://chat.openai.com

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References

  1. Allen KB, Thourani VH, Naka Y, et al. Randomized, multicenter trial comparing sternotomy closure with rigid plate fixation to wire cerclage. The Journal of thoracic and cardiovascular surgery. 2017;153:888-896 e881.
  2. Cahalin LP, Lapier TK, Shaw DK. Sternal Precautions: Is It Time for Change? Precautions versus Restrictions - A Review of Literature and Recommendations for Revision. Cardiopulm Phys Ther J. 2011;22:5-15.
  3. Park JS, Kuo JH, Young JN, Wong MS. Rigid Sternal Fixation Versus Modified Wire Technique for Poststernotomy Closures: A Retrospective Cost Analysis. Annals of plastic surgery. 2017;78:537-542.
  4. Allen KB, Thourani VH, Naka Y, et al. Rigid Plate Fixation Versus Wire Cerclage: PatientReported and Economic Outcomes From a Randomized Trial. The Annals of thoracic surgery. 2018.
  5. Nazerali RS, Hinchcliff K, Wong MS. Rigid fixation for the prevention and treatment of sternal complications. Annals of plastic surgery. 2014;72 Suppl 1:S27-30.
  6. Raman J. Rigid plate fixation promotes better bone healing after sternotomy. Seminars in thoracic and cardiovascular surgery. 2012;24:147-150.