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NCT Number: NCT05953259

RCT to Evaluate STERN FIX Device as a Sternal Stabilization System in Patients After Sternotomy

The goal of this clinical trial is to compare the safety and performance of the sternal stabilization system STERN FIX with the standard of care (sternal closure with wires only) in normal conditions of use, in patients of risk undergoing median sternotomy during cardiothoracic surgery. The main question it aims to answer is:

• whether STERN FIX is a safe and efficient device to close the sternum after a sternotomy in patients of risk, achieving higher sternal stability than wires one month after surgery Participants will have their median sternotomy closed using STERN FIX in combination with wires or wires only at the end of their cardiothoracic surgery, according to the allocated treatment.

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Key information

Conditions

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Universitätsklinikum Freiburg, Freiburg im Breisgau, Baden-Wurttemberg, Germany

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patient undergoing surgery that requires median sternotomy
  • Patients with at least one of the following risk criteria: obesity (BMI>30), diabetes, COPD, non serious osteoporosis (not associated with fractures), creatinine > 200 µmol/L and/or under dialysis treatment, scheduled Bilateral Internal Mammary Artery (BIMA) grafting
  • Patients willing and capable of granting informed consent to participate in clinical research and who have granted written consent
  • Patient willing and capable of complying with the protocol requirements

Exclusion criteria

  • Patient with suspected or known allergies or intolerance to the device material (PEEK - polyether-ether-ketone and carbon fibre)
  • Patient with insufficient quality or quantity of bone or any other serious structural bone damage at the sternum
  • Patient with serious osteoporosis (associated with fractures) or a degenerative bone disease affecting the sternum
  • Patients with a latent or active infection or inflammation at the surgical area, that according to the surgeon criteria may interfere in the device implantation or proper function.
  • Patient with sternal anomalies that, according to the surgeon criteria, prevent the use of the product, such as bone tumours in the implantation area.
  • Pregnant patients or patients planning to become pregnant during the first 6 months after surgery.
  • Patients with diagnosis of dementia with a mental status score (MMSE) < 20.
  • Patients with life expectancy lower than 6 months.
  • Patients involved in other interventionist clinical trials or that have been involved in other interventionist clinical trials during the previous 4 weeks
  • Parasternal sternotomy.
  • Patients with intraoperative conditions that, according to the surgeon's opinion, require or exclude the use of a specific sternal closure system, or that cannot be closed following the study products instructions for use.

IMPORTANT: When the allocated closure method is wires only, the surgeon must assess whether the patient could have also had STERN FIX implanted in order to decide if the patient can continue in the study.

Treatment and study plan

Combination of STERN FIX and wires

Device

Closure of the median sternotomy using a combination of at least one STERN FIX device and wires for a total of 5 fixation points.

Wires

Device

Closure of the median sternotomy using the standard of care with steel wires.

Primary outcomes

  1. Sternal stability

    Time frame: 1 month after surgery

    The primary outcome of this study will evaluate the sternal stability through clinical assessment using the sternal instability scale (SIS) with grades 0 to 3 where 0 is "Clinically stable sternum" and 3 is "Completely separated sternum - entire length"

Secondary outcomes

  1. Safety SAE/AE prevalence

    Time frame: 6 months after surgery

    All adverse events occurring during the study period will be recorded, except for frequent events after surgical interventions requiring median sternotomy.

  2. Safety SAE/AE causality

    Time frame: 6 months after surgery

    All adverse events occurring during the study period will be recorded, except for frequent events after surgical interventions requiring median sternotomy.

  3. Prevalence of device deficiencies

    Time frame: 6 months after surgery

    Adverse event related to the use of an investigational medical device. This includes adverse events resulting from insufficient or inadequate instructions for use, deployment, implantation, installation, or operation, or any malfunction and events resulting from use error or from intentional misuse of the investigational medical device.

  4. Reinterventions - prevalence

    Time frame: 6 months after surgery

    Prevalence of reinterventions

  5. Reinterventions - Causality

    Time frame: 6 months after surgery

    Causality of reinterventions

  6. Prevalence of sternal wound infections

    Time frame: 1 month and 6 months after surgery

    Prevalence of sternal superficial and deep wound infections

  7. Prevalence of dehiscence

    Time frame: 1 month and 6 months after surgery

    Prevalence of dehiscence (without infection)

  8. Sternal closure time

    Time frame: Surgery

    Measured time from the implantation of the first wire to the closure of the last wire (minutes)

  9. Easiness of use of the closure method

    Time frame: Surgery

    The surgeon perceived difficulty of the sternal closure method will be recorded using the Likert scale (1 to 5).

  10. Surgeon satisfaction of the closure method

    Time frame: Surgery

    General surgeon satisfaction with the sternotomy closure method will be recorded using the Likert scale (1 to 5).

  11. Chest pain

    Time frame: Before surgery, 3 and 7 days postoperatively, during the first month and during 6 months postoperatively

    Patients will assess their chest pain using the NRS (0 to 10) while resting and after forced cough

  12. Blood loss

    Time frame: During the first 12 hours postoperatively

    Total blood loss volume obtained from thoracic drainage during the first 12 hours postoperatively will be recorded (mL).

  13. Upper Limb functional index

    Time frame: Before surgery, one month and 6 months postoperatively

    Patients will assess their upper limbs functional capacity using the Upper Limb functional index (ULFI-Sp)

  14. Quality of life - EQ5D5L

    Time frame: Before surgery, one month and 6 months postoperatively

    Patients will complete the EQ-5D-5L questionnaire

  15. Sternal halves union/malunion

    Time frame: 6 months after surgery

    Using CT scan images, the separation between the two sternal halves will be measured in mm. Later on, these measurements will be classified as:

    • Malunion: more than 3mm of separation
    • Mild malunion: between 1 and 3mm of separation
    • Union: less than 1mm of separation
  16. Sternal halves alignment

    Time frame: 6 months after surgery

    Using CT scan images, the alignment between the two sternal halves will be assessed and classified as:

    • Misalignment: <50% alignment between sternal halves
    • Aligned: >50% de alignment between halves
  17. Sternum integrity

    Time frame: 6 months after surgery

    Using CT scan images, the presence of bone cuts, fractures or necrosis will be assessed.

  18. Closure system integrity

    Time frame: 6 months after surgery

    Using CT scan images, the sternal closure devices integrity will be assessed

Sponsors and collaborators

Lead sponsor

NEOS Surgery

Industry

Collaborators

  • Complejo Hospitalario de Navarra
  • Hospital Clinic of Barcelona
  • Universitätsklinikum Freiburg

Registry information

Official study title

Randomised Controlled Clinical Trial to Evaluate STERN FIX Device as a Sternal Stabilization System in Patients After Sternotomy

Acronym: FIXTER-2

Important dates

Study start
2023
Primary completion
2025
Study completion
2025
First posted
Jul 20, 2023
Registry last updated
Sep 22, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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