Sternal Nonunion Treated by Radiofrequency Thermocoagulation of the Anterior Cutaneous Branch of the Intercostal Nerve: A Case Report.

Background: For painful sternal nonunion, conservative treatment by radiofrequency thermocoagulation nerve block of the anterior cutaneous branch of the intercostal nerve can be indicated when surgery is not feasible.

Case report: A 44-year-old man with a history of open-heart surgery was referred to our department due to a complaint that was strongly suspected to be associated with stress. He wished to restart archery, however, doing so was difficult due to the painful sternal nonunion. Surgical treatment and external fixation were not appropriate due to his past medical history and desire to resume archery. Radiofrequency thermocoagulation (90°C, 120 seconds) of the anterior cutaneous branch of the intercostal nerve was performed because he had only 2 tender points. After performing thermocoagulation several times to achieve long-term analgesia, the patient was allowed to resume archery.

Conclusions: Radiofrequency intercostal nerve thermocoagulation is an effective conservative treatment for sternal nonunion pain.