Figure 35b. (a, b) Frontal (a) and lateral (b) views show a sternal fixation pin or Kirschner wire. This sternal fixation was used for a patient who underwent lung transplantation in which a "clamshell" chest incision was made, resulting in a transverse sectioning of the sternum. In this case, the sternum is best stabilized by a vertical fixation wire or pin. Note also the surgical clips overlying the heart and the root of the aorta. (c) Collimated view of a cardiac surgery patient shows a Synthes Maxillofacial Sternal Fixation System (Synthes, Paoli, Pa) (arrows).