Evaluation of Primary Plating in Sternotomy Patients for Osteosynthesis and Pain

Inclusion Criteria: * Patients undergoing median sternotomy; * Patients eighteen (18) years of age or older; * Patients presenting two or more risk factors such as diabetes mellitus, Chronic Obstructive Pulmonary Disease, obesity (BMI \> 30), osteoporosis, Renal failure, Chronic steroid use, Immunosuppression, Redo sternotomy, Neurologic dysfunction severely affecting ambulation, * Off mid-line sternotomy * bilateral IMA use * Long cardio-pulmonary bypass runs * Transverse fractures of the sternum Exclusion Criteria: * Patients with a non-standard sternotomy; * Patients with an off-midline sternotomy that reduced the bony margin to \<2mm * Patients under eighteen (18) years of age; * Patients that are pregnant or currently lactating; * Patients presenting intra-operative conditions that would require the use of rigid fixation and/or additional post-sternotomy mechanical support beyond wire cerclage due to surgical evaluation, * Patients defined within the New York Heart Association (NYHA) or Canadian Cardiovascular Society (CCS) functional Class IV for congestive heart failure, * Patients presenting emergent/salvage cardiac acuity as defined per the Society of Thoracic Surgeons (STS) guidelines: i.e., patients undergoing cardiopulmonary resuscitation en route to the operating room or prior to induction of anesthesia; * Patients undergoing post-operative revision procedures that treat the original sternotomy in such a way as to affect outcome (antibiotic irrigation, debridement or other treatment to the osteotomy); * Patients unwilling or unable to return for follow-up; * Lacking the ability to follow instructions; * Intraoperative death.