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What is the cause of loosening of sternal wires?

Q: My husband had a bypass heart surgery. Sometime after the surgery, his doctor took a chest X-ray and found that his wiring had come loose. I believe they sent him back to work too soon. The doctor rewired his sternum. But he was still experiencing pain in the area. He had incisional hernia. How often does this happen?

A:This kind of a problem of the sternal wires cutting through generally occurs in elderly age group and in patients with friable and weak sternum. It can occur in roughly 3-5% of patients and is not related to your early return to work. Also, I personally do not feel that any doctor would not be interested in his patient’s welfare or would not like to do, what ever is really needed. As I see from your email, the concerned surgeon has already rewired the sternum and I think that is what best a doctor can do. Sometimes, post operatively, pain continues and it may be related to a lot of factors which are totally out of control of the surgeon. I think there seems to be some communication gap and if you contact your surgeon once again, you would be able to get a patient hearing to your problems. The other point I would like to add is that even if there is some sternal instability left, as the time passes, scar tissue is laid down and the sternum tends to become stable. So it is important that you give time in these matters and let nature take care of some of these problems rather than going back again and again to the operating theatre for fixing minor sternal movements.

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