Sternal Cleft Reconstruction: A 12-year Follow-up and Technique Modification

Management of sternal cleft defects presents a rare reconstructive challenge. The primary goals of surgical repair are to optimize pulmonary mechanics, protect mediastinal structures, maintain the growth potential of the chest wall, and improve cosmesis. In 2013, the senior author first described a technique for a superior partial sternal cleft repair. This approach involved longitudinal division and partial resection of the sternum, followed by bilateral sternoclavicular and costochondral releases of the first and second ribs to facilitate tension-free, anatomic closure of the sternal edges. The resected sternal segments were morcellated and used as a bone graft to bridge the gap between the clavicular heads and the sternum following medialization. Soft tissue coverage was achieved with bilateral pectoralis major muscle flaps. In this report, we present successful 12-year follow-up data from the original patient and an adaptation of this technique, based on the long-term outcomes of the original case. This modified technique may serve as an effective approach for the surgical correction of superior partial sternal clefts.