Median sternotomy is one of the most common procedures for various surgical cardiothoracic procedures. The surgical procedure involves splitting the sternum to gain access to the heart and lungs [1].  Other indications for sternotomies include esophagectomy, congenital heart disease, and retrosternal goiter access. Previous studies have shown that sternotomies reduce both short and long term morbidity [2]. Complications of sternotomies are infrequent, but can include, early postoperative infections, technically related and long term complications. A useful method of considering post-sternotomy complications involves dividing into differential diagnoses that are likely in the presternal, sternal, and post-sternal compartments. Unpredictable risks of median sternotomies encompasses wire breaks, wire and screw migrations, post sternotomy pain syndrome, chest wall discomfort, sternal dehiscence, infections and complications from sternal plating. Sternal wire fractures are the most common sternal hardware complications and can present with pain, clicking with movement or protrusion through subcutaneous tissue/skin [3]. Sternal dehiscence often stems from instability with a sternotomy approach and can be rectified using different sternal wire closure techniques [4].

 In this study, we review several issues and complications associated with median sternotomy and review the various imaging modalities for diagnosis.