PMC8203052_01
Standard chest X-rays (A) and CT scan (B) confirming the
diagnosis of manubriosternal disruption.
AJTCCM-26-4-022-fig1.jpg
PMC8203052_01_AJTCCM-26-4-022-fig1.jpg
F1
Standard CXR and computed tomography (CT) scans confirmed the diagnosis of manubriosternal disruption (Fig. 1).
(A) Anatomical landmarks.
. (B) Perioperative image of
manubriosternal dislocation showing incision of the skin, cutaneous
layer and periosteum according to landmarks.
. (C) Sternal closure using
stainless steel wires.
. (D) Postoperative image showing intra-mediastinal
drains with six steel wires
AJTCCM-26-4-022-fig2.jpg
PMC8203052_01_AJTCCM-26-4-022-fig2.jpg
F2
It was decided to fix the  sternal dislocation under general anaesthesia with single lumen intubation in a supine position (Fig. 2).
Clinical picture of the patient before surgery and 6 months later
AJTCCM-26-4-022-fig3.jpg
PMC8203052_01_AJTCCM-26-4-022-fig3.jpg
F3
No. complications were observed at 4 weeks and 6 months of follow-up care (Fig. 3). 
Anatomical landmarks (jugulum and xiphoid).
. (A) Median
sternotomy with Lebsche sternotomie.
. 
(B) Sternal closing with six steel
wires gauge number 5.
. 
(C) MSJ stabilisation with one X-shaped steel wire.
AJTCCM-26-4-022-fig4.jpg
PMC8203052_01_AJTCCM-26-4-022-fig4.jpg
F4
Prior to the incision, the correct anatomical landmarks (jugulum and xiphoid) were identified (Fig. 4A). The osteotomy was performed the whole length of the sternum, just as in the case for a conventional sternotomy (with Lebsche sternotomy) (Fig. 4B). The other steel wires were placed horizontally through the corpus manubriosternal (Fig. 4C).