Primary repair of sternal cleft: a ten-year single-center experience

Sternal cleft (SC) is a rare congenital chest wall malformation that can compromise both physiological function and psychological well-being. This study reviewed a single-center experience with primary SC repair over a ten-year period. A retrospective review was conducted of all patients with SC who underwent surgical repair between January 2014 and December 2024. Clinical characteristics, operative details, and perioperative complications were analyzed. Long-term outcomes were assessed by telephone interviews focusing on cosmetic satisfaction, cardiopulmonary function, and psychological health. Included in the study were 11 patients (4 males, 7 females) with a median age of 5 months (IQR 1.7–35) and weight of 7.4 kg (IQR 5.2–12.3) at surgery. Simple sternal approximation was performed in three cases (27.3%) and autologous tissue reconstruction in eight cases (72.7%). Early postoperative complications included transient pulmonary findings and one case of pericardial effusion, all of which resolved with conservative management. Over a median follow-up of 5.3 years (IQR 3.6–9.3), no deaths or reoperations occurred, and computed tomography confirmed stable osseous fusion with restoration of the thoracic contour. Late complications were limited to mild sternal protrusion or depression and surgical scarring. Telephone follow-up revealed high parental satisfaction, with no reports of cardiopulmonary dysfunction or psychological distress. Primary repair of SC is safe and effective, providing durable cosmetic and functional outcomes without prosthetic materials. Continued follow-up is warranted to monitor thoracic growth during adolescence.