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Case: An osteoporotic and kyphotic 72-year-old woman presented with sternal pain, severe chest instability, and shortness of breath secondary to a traumatic sternal nonunion resulting from an unhealed sternal fracture sustained in a motor vehicle accident several months earlier. One-year functional and radiographic outcomes are presented with complete resolution of symptoms. Conclusion: Consideration for treatment with multiplanar, contourable, locked plating, augmented by autogenous graft, is warranted in the setting of sternal deformity and nonunion, particularly in the setting of osteoporosis and other sagittal plane deformity.

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