Intramedullary reinforcement of sternal fixation with autologous xiphoid tenon

Minimally invasive cardiac surgery through a partial sternotomy or a ministernotomy is popular. However, the transverse nonunion of the sternum will be a potential complication. Valid and valuable techniques have been introduced for securing the sternotomy fixation. Most of them are focused on the materials or methods for extrinsic reinforcement. A new concept, focused on the intramedullary reinforcement of the sternal fixation, was designed by incarcerating a cancellous portion of the autologous xiphoid in the marrow space of the inter-segmental junction of the partial sternotomy. This autologous xiphoid tenon method is simple, reliable, and reproducible without additional requirement of device implantation or an iliac incision for the bone grafting.