P118. RECONSTRUCTION OF STERNAL NONUNION USING THE STERNAL TALON SYSTEM; AN 11-YEAR EXPERIENCE

Abstract

PURPOSE: Closure after sternotomy is frequently performed with wiring. In patients with sternal nonunion, the Sternal Talon (KLS Martin Group) may achieve bony union more predictably without relying on transosteal hardware in unhealthy bone for osteosynthesis. METHODS: An IRB-approved review was conducted of all patients undergoing Sternal Talon reconstruction by the senior author between 2010-2021. Patient comorbidities, reconstructive indication, and surgical history was reviewed. Nonunion classification, number of Talon devices utilized and concurrent procedures were recorded. Outcomes included pain relief postoperatively, chest wall stability, and evidence of sternal union, assessed using standard summary statistics. RESULTS: 22 patients (ages 49-83) underwent ORIF using the Sternal Talon for sternal nonunion in all but 2 patients with a nickel allergy precluding wiring. Index cardiac procedure included: CABG (77%), valve replacement (18%), and heart transplant (5%). 1-4 Talons were used: 1 (13.6%), 2 (22.7%), 3 (50%), 4 (13.6%). All patients presented with sternal pain/instability, 2 had failed conventional ORIF. Average time to Talon ORIF was 12.6 +/- 11.8 months. At an average of 15.1 +/- 15 months follow-up, sternal union was present in 100% of patients and 91% demonstrated relief of pain/instability. 2 wound infections & 1 hematoma occurred. 3 patients required prominent hardware removal. CONCLUSION: The Sternal Talon device represents a reliable method of achieving sternal union in high-risk patients with an acceptable side effect profile.