Characterizing twist-to-writhe wiring technique for sternal closure following median sternotomy: biomechanical analysis.
Document Type
Article
Publication Date
6-1-2026
Abstract
OBJECTIVE: Wire fracture during sternal closure following median sternotomy poses significant risks, including sternal dehiscence. This study introduces and evaluates a novel "twist-to-writhe" technique aimed at reducing the risk of wire fracture while maintaining adequate sternal closure.
METHODS: Ten foam sternum models per group were used and bisected to simulate median sternotomy. Each foam sternal model was closed with five sternal wires using either the twist-to-writhe (experimental) technique or the traditional (control) technique. In the twist-to-writhe method, wire ends that were cleaved were left at 10 centimeters (cm) before twisting with a wire twister. In the traditional method, wire ends were cut to 1 cm before twisting. Compressive forces at several sternal points were measured.
RESULTS: The average compressive forces across four key sternal points were similar between the twist-to-writhe and traditional methods (167.45 ± 5.96 newton (N) vs. 172.92 ± 7.41 N,
CONCLUSION: The twist-to-writhe technique may reduce the incidence of wire fractures without compromising sternal approximation or closure quality. Further clinical validation is needed to confirm these findings.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12055-026-02177-w.
Publication Title
Indian J Thorac Cardiovasc Surg
Volume
42
Issue
6
First Page
778
Last Page
782
Recommended Citation
Cho, P., Viswanathan, A., Breckenridge, L., Strand, K., Hast, M., & Dasika, U. (2026). Characterizing twist-to-writhe wiring technique for sternal closure following median sternotomy: biomechanical analysis.. Indian J Thorac Cardiovasc Surg, 42 (6), 778-782. https://doi.org/https://doi.org/10.1007/s12055-026-02177-w