Sternal Closure With Rigid Plate Fixation Versus Wire Closure: A Randomized Controlled Multicenter Trial Jaishankar Raman, MD, PhD, Sven Lehmann, MD,

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Sternal Closure With Rigid Plate Fixation Versus Wire Closure: A Randomized Controlled Multicenter Trial Jaishankar Raman, MD, PhD, Sven Lehmann, MD, Kenton Zehr, MD, Brian J. De Guzman, MD, Lishan Aklog, MD, H. Edward Garrett, MD, Heber MacMahon, MB, BCh, Brian M. Hatcher, PhD, Michael S. Wong, MD The Annals of Thoracic Surgery Volume 94, Issue 6, Pages 1854-1861 (December 2012) DOI: 10.1016/j.athoracsur.2012.07.085 Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Axial computed tomography scan images representative of each score on 6-point scale. Each score was defined as follows: (A) 0 = no sign of healing (clear lack of healing, nonunion, sternal separation); (B) 1 = minimal healing (sternal separation, lack of bridging bone); (C) 2 = mild healing (sternal separation with hazy, immature bone formation); (D) 3 = moderate healing (partial bridging bone indicative of sternal stability); (E) 4 = partial synthesis (significant bridging bone); and (F) 5 = complete synthesis (complete bridging bone). The Annals of Thoracic Surgery 2012 94, 1854-1861DOI: (10.1016/j.athoracsur.2012.07.085) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Representative computed tomography scans for (A) rigid plate fixation patients and (B) conventional wire cerclage patients at 3 months. Axial images are from patients with computed tomography scores representative of mean values for their respective group. The Annals of Thoracic Surgery 2012 94, 1854-1861DOI: (10.1016/j.athoracsur.2012.07.085) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Representative computed tomography scans for (A) rigid plate fixation patients and (B) conventional wire cerclage patients at 6 months. Three-dimensional scan reconstructions are from patients with computed tomography scores representative of mean values for their respective group. Rigid plate fixation patient on left had mean score of 4.0, and conventional wire cerclage patient on right had mean score of 2.2. The Annals of Thoracic Surgery 2012 94, 1854-1861DOI: (10.1016/j.athoracsur.2012.07.085) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions