Osteomyelitis of the sternum most commonly occurs after which procedure, especially in diabetics?

• A. Median Sternotomy Incisions
• B. Laparotomy
• C. Thoracentesis
• D. Cardiac Catheterization

Answer: (A)

Osteomyelitis of the sternum most often follows direct exposure and manipulation of the sternum during median sternotomy, the common approach used in open-heart surgery. When the sternum is divided and later reapproximated with wires, it creates a setting where bacteria can seed the bone, especially if a wound infection develops. In diabetics, this risk is amplified because of impaired wound healing, reduced blood flow to tissues, and altered immune function, making infection of the sternum more likely and more difficult to eradicate.

The other procedures involve incisions away from the sternum or only puncture/limited access to the chest, so they do not place the sternum at direct risk for bone infection. Laparotomy targets the abdomen, thoracentesis involves the pleural space with minimal sternum impact, and cardiac catheterization uses percutaneous access with little sternum trauma, all resulting in a much lower chance of sternum osteomyelitis.