WOFAPS 2025 8th World Congress of Pediatric Surgery

Lana Kuzminykh, Alexey Podkamenev, Vadislav Avramenko, Roman Ti, Vladislav Dvoretsky, Arina Syrtsova, Olga Murashova, Damir Malekov

Saint-Petersburg State Pediatric Medical University

As a rare congenital thoracic deformity, the sternal cleft needs to be treated by surgery. It happens more often in females. The deformity can be partial or complete. Primary repair surgery must be done as soon as possible, best during the neonatal period, when simple surgical technics achieve remarkable results.

Sternal cleft can be repaired using an autologous or a synthetic graft. Different technics for repairing a sternal cleft are described. Here we present a simple surgical one-step method using orthopedic TightRope System. The patient was born at term with visible suprasternal pathological movements and scarlike tissue in the middle of the chest. A newborn female had no other congenital deformities, symptoms or diseases. Plain chest radiographs showed a gap between sternal bars. Based on thoracic computer tomography (CT) with reconstruction, we confirmed the presence of a superior congenital sternal cleft. The extent of the sternal cleft was 25 mm according to 3D CT reconstructions. To remove the deformity, restore bone-protected mediastinal structure and to set normal intrathoracic pressure, we decided to use surgical correction with TightRope system. The patient was discharged and instructed to return at the age of 12 months for a controlled CT and the simple removal of the TightRope system.

In summary, we present a new technic for partial sternal cleft repair using the TightRope system, which can be performed as a single surgical procedure and reduce the risk of mediastinal compression and cardiorespiratory disorders during closure.