Fente sternale : intérêt d’une prise en charge chirurgicale néonatale

Successful surgical repair of a sternum cleft using composite mesh: A case report and new technical note

“…[5][6] Moreover, studies have suggested that it is always preferable to use autogenous tissue for sternal cleft repair and to avoid the use of prosthetic materials, recognising the risk of infection and the negative impact of inert material on the patient's development. [1,4,8] Despite the risk of infection described in the literature, the use of prosthesis in sternal cleft repair has an advantage in preventing an increase in intrathoracic pressure such as explained in our technical note. [17] In addition, this surgical approach avoids major surgical dissection and the use of autogenous or bone bank rib reconstruction, which presents a potential risk of aseptic or septic necrosis of the bone.…”

“…[12] Other hypotheses have been suggested, such as abuse of alcohol consumption, nutritional deficiencies and hypovitaminosis (methylcobalamin, riboflavin) during pregnancy but have not been proven. [3,8] There is no reported justification for the predominantly female prevalence of the condition. [3][4][5] However, studies by Gorlin et al [13] and Heron et al [14] showed a predominance of females when the sternal cleft is associated with a bandlike scar from the umbilicus and diastasis recti.…”

“…[5][6] Historically, Lannelongue [1] carried out the first surgical repair of a complete sternal cleft in 1988. Burton [8] published two cases of successful surgical repair by implanting a cartilage graft in the defect in the bone in 1947. Subsequently, Maier and Bortone [16] carried out direct closure of two hemi-sternums in infants who were 6 weeks old and this technique has become the reference.…”

“…Only two other similar cases, to our knowledge, have been reported in the literature. [8 , 9] The most common defect is the partial superior form, which affects the upper sternum and the manubrium with normal fusion of the lower part. [5 , 6] Inferior defects are extremely rare and usually associated with complex syndromes like Cantrell pentalogy.…”

First Sternal Cleft Repair Using a Porous Alumina Ceramic Prosthesis in a 9-Year-Old Child

“…5 Because of higher compliance of the thoracic cage associated to a minimal compression of underlying structures in young children, early surgery is usually preferred. 6 However, when sternal cleft closure has been delayed, the best approach for surgical treatment remains unclear. A lot of clinical cases using various surgical technics are reported, but it is difficult to draw conclusion about the gold standard technique.…”