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. 2013 Aug 29;2013(8):rjt049.
doi: 10.1093/jscr/rjt049.

Stable construction of the sternum after broad radical resection of malignant tumours

Sven A F Tulner  1 , M Petrousjka van den Tol  2 , Sybren Meijer  1
Affiliations

Stable construction of the sternum after broad radical resection of malignant tumours

Sven A F Tulner et al. J Surg Case Rep. .

Abstract

Radical resection of primary or solitary secondary malignant sternal tumours is indicated in patients without metastases. Sternal reconstruction may be indicated in large defects to prevent pulmonary complications, to achieve protection of intra-thoracic organs and to obtain a good aesthetic result. In this article, a modified surgical technique is described to fill and reconstruct large defects after radical resection of a primary or secondary malignant sternal tumour. The technique makes use of a methyl methacrylate composite within two layers of polypropylene mesh enforced by steel wires through the sternal ends of the defect enhancing stability. This modified technique can be easily applied, making curative broad radical resections of the sternum feasible.

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Figures

Figure 1:
Figure 1:
A MRI scan of a patient showing a tumour involving the manubrium extended to the first and second ribs including the right clavicle and sternoclavicular joint.
Figure 2:
Figure 2:
The axillar slides of the MRI of the patient showing the ingrowth of the tumour in the thoracic cavity in relation to the intrathoracic organs.
Figure 3:
Figure 3:
Schematic drawing of the size of the defect after radical excision followed by placing steel wires through the stenal ends.
Figure 4:
Figure 4:
This picture shows the size of the defect in the patient after radical resection, which was 6.5 centimetres. Consequently, steel wires were placed through the sternal ends and the left sternoclavicular joint and a polypropylene mesh was place on the surface of the defect.
Figure 5:
Figure 5:
Schematic drawing showing a polypropylene mesh filled with methyl methacrylate composite to reconstruct the sternal defect.
Figure 6:
Figure 6:
Around these steel wires a polypropylene mesh was placed filled with methyl methacrylate composite to reconstruct the sternal defect.
Figure 7:
Figure 7:
Schematic drawing showing the final reconstruct after tumour resection of the sternum.
Figure 8:
Figure 8:
This picture shows the final reconstruct after tumour resection of the sternum in the patient.
See this image and copyright information in PMC

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