Sternal cleft—a natural absurdity or a surgical opportunity

Sternal cleft, Morgagni hernia, and ectopic liver: a unique chest wall anomaly

“…Diagnosis in the neonatal period presents a surgical opportunity for primary closure of the sternum without autologous or prosthetic grafts, owing to a very compliant and flexible chest wall [1][2][3]. Missing this opportunity typically leads to more complex repairs involving chondrotomies, autologous tissue, or prosthetic grafts in older children [3][4][5]. In our case, sternal reconstruction was rather easily performed by mobilizing the sternal bars and closing them primarily followed by approximation of the pectoralis muscles.…”

“…However, late presentations have also been reported [3][4][5]. Diagnosis in the neonatal period presents a surgical opportunity for primary closure of the sternum without autologous or prosthetic grafts, owing to a very compliant and flexible chest wall [1][2][3].…”

“…Although the true incidence is unknown, less than 100 cases, mostly in the form of case reports or small case series, have been reported in the literature [1][2][3][4][5]. An electronic database search revealed a single case report of a neonatal sternal cleft associated with an extrathoracic mass [1], as well as a single case of ectopic liver tissue protruding through a sternal defect [6].…”

Autologous repair of isolated complete sternal cleft in an adolescent

“…Various prosthetic grafts such as Teflon, polypropylene, silicone, and titanium have been used in adults to cover a wider defect, but these materials provide a rigid frame and are associated with increased infection and synthetic reaction [12].…”

Intrauterine diagnosed sternal cleft patient and her management

“…Sternal cleft is a rare congenital anomaly which results from failure of fusion of the mesodermal sternal bars by 8 weeks of gestation (1)(2)(3). The rest of the sternum and its association with the ribs laterally usually develops normal.…”