Superior sternal cleft: construction with a titanium plate

Area of Science:

• Pediatric Surgery
• Congenital Malformations
• Cardiovascular Surgery

Background:

• Sternal cleft is a rare congenital deformity, with superior sternal cleft being the most common type.
• Sternal clefting is often associated with vascular dysplasia, but specific co-occurrences can be rare.

Observation:

• This report presents the first documented case of a superior sternal cleft in a neonate with cervicofacial hemangiomata and cardiac defects.
• The neonate did not exhibit true ectopia cordis, distinguishing this case from others with severe sternal defects.

Findings:

• Early surgical intervention for sternal clefting, ideally within the first four weeks of life, is advocated.
• The recommended surgical approach involves primary approximation, reinforced with a titanium plate for rigid internal fixation and reduced tension.
• Titanium plates promote osseointegration, leading to a stable, solid bony sternum post-repair.

Implications:

• This case highlights a unique association of congenital anomalies, emphasizing the need for comprehensive evaluation in neonates with sternal clefts.
• The proposed surgical technique using titanium plates offers a robust solution for sternal approximation, improving long-term stability.
• Timely surgical management is crucial for improving outcomes in neonates with sternal cleft deformities and associated conditions.