THE STABILITY OF INTERLOCKING STERNOTOMY TECHNIQUE ON JAVA GOAT STERNUM (CAPRA AEGAGRUS HIRCUS) IN VITRO BASED ON BIOMECHANICAL ANALYSIS
1Jayarasti Kusumanegara, Heroe Soebroto
Background: The stability of the sternum approximation is an important factor in preventing post-sternotomy complications in cardiac surgery caused by unstable sternum. The stability of the sternotomy can also be enhanced by the selection of good osteotomy techniques. The most common sternotomy technique is the median sternotomy. Objective: To compare interlocking sternotomy technique with straight sternotomy technique on sternum stability of Javanese goat (Carpa aeragrus hircus) in vitro based on biomechanical analysis. Methods: This in vitro study used 42 goat sternum bones. There were 21 sternums performed interlocking sternotomy and other 21 sternums were performed straight sternotomy. Sternotomy was conducted by using manual saws. Both halves of the sternum were fixed with a stitch of the figure of eight using a stainless-steel wire of 6 metric sizes. The yan biomechanical test consisted of transverse shear, longitudinal shear, and lateral distraction tests were performed on each group (7 sternums for each type of test) with loading from 100 Newtons to 400 Newtons of 0.2 Hertz. Results: The average surface area of sternal fragments in interlocking sternotomy (19.6 cm2) was greater than in straight sternotomy (18.2 cm2). In the longitudinal shear and transversal shear tests, interlocking sternotomy was better than straight sternotomy and the difference was statistically significant (p <0.05). However, in the lateral distraction test, there was no significant difference in both techniques (p >0.05).
Interlocking Sternotomy, Straight Sternotomy, Biomechanics, transversal shear, longitudinal shear, lateral distraction