Repair of congenital sternal cleft in infants and adolescents
J R de Campos1, L T Filomeno, A Fernandez
1Thoracic Division, Hospital das Clínicas, University of São Paulo Medical Center, Brazil. jribas@usp.br
Insights
Surgical repair of sternal clefts using autologous tissue is effective for older patients when neonatal repair isn't possible. This method provides good aesthetic and structural outcomes, avoiding prosthetic complications.
Area of Science:
- Pediatric surgery
- Thoracic surgery
- Congenital anomalies
Background:
- Sternal cleft is a rare congenital condition.
- Neonatal repair is ideal but often not feasible.
- Autologous repair avoids complications associated with prosthetic materials.
Purpose of the Study:
- To present clinical and surgical aspects of sternal cleft repair in older patients.
- To evaluate the efficacy of autologous reconstruction techniques.
Main Methods:
- Review of 8 cases of sternal cleft (not associated with ectopia cordis) between 1979 and 1997.
- Surgical repair involved chondrotomies, posterior sternal wall repair, or combined techniques.
Main Results:
- All patients achieved good aesthetic and structural results post-surgery.
- The mean hospital stay was 5.8 days with an uneventful postoperative period for most.
- Follow-up ranged from 4 months to 18 years.
Conclusions:
- Autologous reconstruction using periosteal flaps and chondral grafts is a simple, effective method for sternal cleft repair in older individuals.
- This technique offers a viable alternative when early repair is missed.
Background:
Clinical and surgical aspects of sternal cleft repair are presented. Primary repair in the neonatal period is the best management for this rare condition, but none of the patients in this report were referred to us during that period. Autologous repair is suitable for older patients because it avoids problems related to the implant of prosthetic materials.
Methods:
This article reviews 8 cases of sternal cleft not associated with ectopia cordis in patients presenting between October 1979 and November 1997. Surgical repair consisted of three sliding chondrotomies, three posterior sternal wall repairs, one combination with the Ravitch technique for pectus excavatum repair, and one posterior sternal wall repair associated with total repair of Cantrell's pentalogy.
Results:
All patients who submitted to surgical correction had good aesthetic and structural results. The postoperative period was uneventful except that a subcutaneous fluid collection developed in 1 patient. The mean hospital stay was 5.8 days. The patients were followed up from 4 months to 18 years.
Conclusions:
Whether dealing with older children or young adults, the technique of reconstructing a new sternum with a posterior periosteal flap from sternal bars and chondral grafts is a simple, quick, inexpensive, and effective option.
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