In a 13-year-old boy a correction of an atrioventricular septal defect (AVSD) was performed at the age of one year and a mitral valve reconstruction at the age of two years. The patient developed, after two median sternotomies, a massive sternal deformity. At the age of 12 years another mitral valve reconstruction had to be performed. At this time titanium plates were used for sternal closure and correction of the deformity. Six months later, and after a CT-follow-up, the plates could be removed with a very satisfying result. Sternal plate osteosynthesis represents an excellent alternative for the correction of difficult sternal closures and deformities in adults as well as in children.