Primary repair of sternal cleft with a double osteochondroplasty flap
Quentin Ballouhey1, Mateo Armendariz, Virginie Vacquerie
1Department of Pediatric Surgery, Children's Hospital, Limoges, France.
Insights
Sternal cleft, a rare chest wall defect, requires early surgical closure in newborns. A novel technique using intercostal sutures and a double perichondrium flap offers excellent anatomical and cosmetic outcomes for treating this congenital malformation.
Area of Science:
- Pediatric Surgery
- Congenital Malformations
- Thoracic Wall Reconstruction
Background:
- Sternal cleft is a rare congenital chest wall anomaly requiring surgical intervention.
- Early neonatal closure is preferred due to the chest wall's flexibility.
- Existing surgical techniques lack proven superiority.
Observation:
- Two cases of sternal cleft repair using an original surgical technique are presented.
- The technique involves dissecting sternal bars, approximating them with intercostal sutures, and employing a double perichondrium flap.
- Close cardiac and respiratory monitoring was maintained during the procedures.
Findings:
- The described surgical technique successfully restored sternal anatomy.
- The double perichondrium flap provided a robust double layer, enhancing the repair.
- Satisfying anatomical and cosmetic results were achieved in both cases.
Implications:
- This original technique offers a viable and effective option for managing sternal clefts.
- The method provides good anatomical restoration and cosmetic outcomes.
- Further studies may validate this approach for broader clinical application in congenital chest wall defects.
Abstract:
Sternal cleft is a rare congenital malformation affecting the anterior part of the chest wall. Surgical closure is recommended. It should be done early during the neonatal period because of the chest's flexibility. Associated abnormalities may have been previously excluded. Different surgical repairs have been described, but none has been proved to be superior to the others. We present the description of 2 cases managed with an original surgical technique. After dissecting the two sternal bars, they were approximated with several intercostal sutures under close cardiac and respiratory monitoring. A double perichondrium flap technique was then used and resulted in a double perichondrium layer. This technique is suitable for most cases and offers satisfying anatomical restoring and cosmetic results.
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