Aa
SX associated with sternal non union
Dr. A. Miller,
From personal experience, I know having an interest in a disease prices keeps clinically sharp. From a web review there are not many who have commented on this entity.
I had a CABG with L IMA and MAZE 20 m ago. About 14 m post op I noticed sternal instability; lateral, longitudinal & transverse. Shortly after that I became aware of ROM limiting shoulder/upper extremity problems. I attributed this to ambulating with a cane for a arthritic R Hip that was replace 6 weeks ago. While at PT for the hip I asked about the shoulder issues. the explanation I received was=>are the pectoralis major and minor, attached to the ribs and drawing the scapulae fwd and the sternum laterally at the same time. These against their antagonists in the back,the lats and anterior serratus. The anterior muscles are in spasm and overwhelming the posterior weak ones. I was given several home exercise to do, to perhaps help this.
Do you believe the non union is contributing? My orthopod notes that pain can arise from a sternal non union. I know this, but the back and shoulder stuff is more ROM limiting than per se sternal pain. The sternal movement is a very peculiar sensation. Do you think getting this repaired would, once healed, help with the ROM limiting shoulder problems?
When this is repaired how much coverage is generally needed over the closure, be it plating, rewiring or talon?
Thank you
From personal experience, I know having an interest in a disease prices keeps clinically sharp. From a web review there are not many who have commented on this entity.
I had a CABG with L IMA and MAZE 20 m ago. About 14 m post op I noticed sternal instability; lateral, longitudinal & transverse. Shortly after that I became aware of ROM limiting shoulder/upper extremity problems. I attributed this to ambulating with a cane for a arthritic R Hip that was replace 6 weeks ago. While at PT for the hip I asked about the shoulder issues. the explanation I received was=>are the pectoralis major and minor, attached to the ribs and drawing the scapulae fwd and the sternum laterally at the same time. These against their antagonists in the back,the lats and anterior serratus. The anterior muscles are in spasm and overwhelming the posterior weak ones. I was given several home exercise to do, to perhaps help this.
Do you believe the non union is contributing? My orthopod notes that pain can arise from a sternal non union. I know this, but the back and shoulder stuff is more ROM limiting than per se sternal pain. The sternal movement is a very peculiar sensation. Do you think getting this repaired would, once healed, help with the ROM limiting shoulder problems?
When this is repaired how much coverage is generally needed over the closure, be it plating, rewiring or talon?
Thank you
COMMUNITY LEADER
I don't know that this will get directed to a dcotor as we don't have doctors in this community on a regular basis. Is he a member of the community at MedHelp or is he with the Cleveland Clinc?
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