Objective To compare the indexes of steel wire and sternal ligation in adult midline incision cardiac surgery and to explore the advantages of sternal ligation. Methods A total of 163 patients who underwent midline incision cardiac surgery in the Department of Cardiac Surgery，the First Affiliated Hospital of Xinjiang Medical University from March 2021 to March 2022 were randomly selected，including sternum band group（n = 61）and steel wire group（n = 102）. The sternal fixation time，analgesic use，postoperative pain simulation score at different time periods，incidence of postoperative complications and treatment costs were compared between the two groups. Results The sternal fixation time of the sternum band group was 14.9（13.9，16.2）min，and that of the steel wire group was 22.1（20.2，24.0）min. The sternal fixation time of the sternum band group was significantly shorter than that of the steel wire group（Z = -9.940，P < 0.001）. The visual analogue score of postoperative pain in sternum band group was significantly lower than that in wire group at different time periods（P < 0.001）. There were statistically significant differences between the sternum band group and the steel wire group in postoperative complications such as surface infection，mediastinal infection，osteomyelitis，sternal debridement and suture（P < 0.05）. There was no significant difference in the length of stay in ICU，total treatment cost and patient payment between the steel wire group and the sternum band group（P > 0.05）. Conclusion Compared with the traditional steel wire，the sternum band has a greater clinical advantage in postoperative pain and postoperative complications.