Reconstruction of the Sternum, Manubrium, and Sternoclavicular Joints With Cadaveric Femur: A Novel Approach

Objective: To describe a novel sternal and sterno-clavicular joint reconstruction technique using cadaveric femoral allograft. Case Description: A 58-year-old male presented with 14.8 cm Grade 1 sternal chondrosarcoma requiring extensive resection and reconstruction. The goal was to create a semi-rigid reconstruction preserving some mobility of the sternoclavicular joint for optimal patient quality of life. After appropriate oncologic resection, a cadaveric femur was fashioned into a neo-sternal profile and anchored to the clavicles and residual basilar sternum using multiple fixation techniques which are discussed below. The final prosthesis was covered by bilateral pectoralis muscle flaps. The patient had an uneventful postoperative course. On 16 months follow-up, the patient was able to carry out normal activities including work, and self-care, with no evidence of graft failure, fracture, and infections and good cosmetic outcome. Conclusions: We have successfully performed a semi-rigid sternal and sternoclavicular joint reconstruction for large, low-grade chondrosarcoma using bio-prosthesis with good short-term patient outcomes and preservation of functionality. Multidisciplinary care is essential for the performance of such complex chest wall reconstructions. Longer-term follow-up will be necessary to determine the durability of the construct over time.