case_images: PMC3603623_01
case_images: Sternocutaneous fistula (arrow).
case_images: CRIM.SURGERY2013-451594.001.jpg
case_images: PMC3603623_01_CRIM.SURGERY2013-451594.001.jpg
case_images: fig1
case_images: Second Department of Propaedeutic Surgery of Athens University with a chest pain and a sternocutaneous fistulous tract discharging pus (Figure 1). Seven weeks earlier, he had undergone a redo coronary artery bypass via median sternotomy.
case_images: The defect after the V sternectomy (arrow). The raising of the pectoralis major muscle flaps (forceps).
case_images: CRIM.SURGERY2013-451594.002.jpg
case_images: PMC3603623_01_CRIM.SURGERY2013-451594.002.jpg
case_images: fig2
case_images: The procedure was started with a V-shape partial sternectomy of the midline (Figure 2).
case_images: Final result after suturing the medial ends of both flaps.
case_images: CRIM.SURGERY2013-451594.003.jpg
case_images: PMC3603623_01_CRIM.SURGERY2013-451594.003.jpg
case_images: fig3
case_images: Finally, the wire passes from the posterior to anterior surface of the flap 1, which created an overlap of the flaps so that the flap 2 was buried in the V scraped area, and the flap 1 was overlapping (Figure 3).
case_images: Postoperative chest wall MRI.
case_images: CRIM.SURGERY2013-451594.004.jpg
case_images: PMC3603623_01_CRIM.SURGERY2013-451594.004.jpg
case_images: fig4
case_images: Postoperative MRI (Figure 4), 6 months after surgery, did not show any pathological finding, and physical examination revealed a normal range of motion for both upper limbs and sternal stability.