Vibration transmittance measures sternotomy stability - a preliminary study in human cadavers.
BACKGROUND
Stability is essential for the normal healing of a sternotomy. Mechanical vibration transmittance may provide a new means of early detection of diastasis in the sternotomy and thus enable the prevention of further complications. We sought to confirm that vibration transmittance detects sternal diastasis in human tissue.


METHODS
Ten adult human cadavers (8 males and 2 females) were used for sternal assessments with a device constructed in-house to measure the transmittance of a vibration stimulus across the median sternotomy at the second, third, and fourth costal cartilage. Intact bone was compared to two fixed bone junctions, namely a stable wire fixation and an unstable wire fixation with a 10 mm wide diastasis mimicking a widely rupturing sternotomy. A generalized Linear Mixed Model with the lme function was used to determine the ability of the vibration transmittance device to differentiate mechanical settings in the sternotomy.


RESULTS
The transmitted vibration power was statistically significantly different between the intact chest and stable sternotomy closure, stable and unstable closure, as well as intact and unstable closure (t-values and p-values respectively: t = 6.87, p < 0.001; t = 7.41, p < 0.001; t = 14.3, p < 0.001). The decrease of vibration transmittance from intact to stable at all tested costal levels was 78%, from stable to unstable 58%, and from intact to unstable 91%. The vibration transmittance power was not statistically significantly different between the three tested costal levels (level 3 vs. level 2; level 4 vs. level 2; level 4 vs. level 3; t-values and p-values respectively t = - 0.36, p = 0.723; t = 0.35, p = 0.728; t = 0.71, p = 0.484).


CONCLUSIONS
Vibration transmittance analysis differentiates the intact sternum, wire fixation with exact apposition, and wire fixation with a gap. The gap detection capability is not dependent on the tested costal level. The method may prove useful in the early detection of sternal instability and warrants further exploration.
['Hautalahti|Juha|J|http://orcid.org/0000-0001-7747-2717', 'Joutsen|Atte|A|', 'Goebeler|Sirkka|S|', 'Luukkaala|Tiina|T|', 'Khan|Jahangir|J|', 'Hyttinen|Jari|J|', 'Laurikka|Jari|J|']
D000328:Adult D000368:Aged D001864:Bone Wires D002102:Cadaver D000070631:Diastasis, Bone D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D012272:Ribs D056346:Sternotomy D013249:Sternum D014732:Vibration
Vibration transmittance Sternotomy Sternum Electronics Integrity Postoperative complications Wound healing