Sternal Cleft: Signs, Causes, And How To Treat

Sternal cleft, also known as sternal fissure, is a rare congenital condition where a cleft or split occurs in the breastbone or sternum. This anomaly happens during fetal development when the bones of the chest fail to fuse properly.

As a result, a gap or opening forms in the middle of the chest, which can vary in size and severity. The exact causes of sternal cleft are not entirely clear, but it is believed to be due to genetic factors or disruptions in the early stages of embryonic development.

While sternal cleft is a rare condition, it can present challenges and require medical attention to address any potential complications. If you or your child have been diagnosed with sternal cleft, your healthcare provider.

Symptoms of Sternal Cleft

Patients with a sternal cleft may experience difficulty breathing, feeding problems, or respiratory infections due to the opening in the sternum. Some individuals may also develop heart or lung issues as complications. It is essential for individuals with a sternal cleft to seek medical attention for proper evaluation and management to address any associated symptoms or potential health risks.

A visible gap in the breastbone, known as the sternum, is a common symptom of sternal cleft.
Breathing difficulties, especially during physical activity, may occur in individuals with sternal cleft.
Chest pain or discomfort can be experienced by some individuals with a sternal cleft condition.
Heart irregularities or murmurs may be present in patients with a sternal cleft anomaly.
A sunken or protruding chest appearance may be noticeable in individuals with a sternal cleft deformity.

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Causes of Sternal Cleft

This failure of fusion can result from genetic factors, such as mutations in certain genes involved in sternal development. Environmental influences, like exposure to teratogenic substances during pregnancy, can also play a role in the development of sternal cleft.

Additionally, disruptions in the signaling pathways critical for proper sternal formation may contribute to this condition. While the exact causes of sternal cleft are not fully understood, a combination of genetic predisposition and environmental factors likely underlie its pathogenesis.

Genetic predisposition can be a cause of sternal cleft, where the development of the chest wall is affected.
Environmental factors, such as exposure to certain toxins during pregnancy, may contribute to the occurrence of sternal cleft.
In some cases, sternal cleft can be linked to underlying congenital syndromes or genetic abnormalities affecting fetal development.
Maternal health conditions like diabetes or obesity could potentially increase the risk of a child being born with a sternal cleft.
Medication use during pregnancy, especially certain teratogenic drugs, has been associated with an elevated likelihood of sternal cleft formation.

Types of Sternal Cleft

Sternal clefts, rare congenital anomalies, are classified into three main types: complete, partial, and bifid. A complete sternal cleft involves a complete separation of the sternum into two halves, while a partial cleft presents as a notch or fissure in the sternum.

The least severe form, a bifid cleft, appears as a minor bifurcation at the lower end of the sternum. These variations in sternal cleft types can range from minor cosmetic issues to more severe conditions requiring surgical intervention for correction.

Complete Sternal Cleft: Involves a full separation of the sternum into two distinct bony segments.
Partial Sternal Cleft: Characterized by a partial division of the sternum, often appearing as a cleft in the lower or upper portion.
Superior Sternal Cleft: Refers to a cleft located in the upper part of the sternum, near the manubrium.
Inferior Sternal Cleft: Occurs in the lower segment of the sternum, closer to the xiphoid process.
Midline Sternal Cleft: A cleft that runs along the midline of the sternum, dividing it vertically.

Risk Factors

Sternal cleft, a rare congenital anomaly where the breastbone fails to fuse properly during development, may have several risk factors. These can include genetic factors, maternal age over 40, certain medications or substances taken during pregnancy, maternal diabetes, and exposure to environmental toxins. While the exact cause of sternal cleft is not always clear, these factors are thought to play a role in increasing the likelihood of this condition.

Early detection and appropriate medical management are crucial in addressing sternal cleft to ensure the best outcomes for affected individuals.

Genetic predisposition: Individuals with a family history of sternal cleft may have a higher risk of developing the condition.
Fetal exposure to teratogens: Maternal exposure to certain drugs, chemicals, or radiation during pregnancy can increase the likelihood of sternal cleft in the newborn.
Presence of other congenital anomalies: Babies born with certain birth defects or syndromes may be at a greater risk of having a sternal cleft.
Maternal age: Advanced maternal age at the time of conception has been associated with an increased risk of sternal cleft in newborns.
Environmental factors: Exposure to environmental pollutants or toxins during pregnancy may contribute to the development of sternal cleft in infants.

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Diagnosis of Sternal Cleft

During the physical exam, the healthcare provider will inspect the chest area for any visible cleft or indentation. Imaging studies help to visualize the extent and exact location of the sternal abnormality, providing valuable information for treatment planning.

In some cases, genetic testing may be recommended to identify any underlying genetic conditions associated with sternal clefts. The diagnostic process aims to accurately assess the condition and guide appropriate management decisions for the individual affected.

Imaging studies such as X-rays and CT scans can help diagnose a sternal cleft by visualizing the defect.
A physical examination by a healthcare provider may reveal the presence of a sternal cleft through observation and palpation.
Genetic testing may be recommended to identify any underlying genetic conditions associated with a sternal cleft.
Consultation with a pediatric surgeon or a specialist in congenital anomalies is crucial for a comprehensive evaluation and treatment plan.

Treatment for Sternal Cleft

Treatment options for sternal cleft, a rare congenital condition where the breastbone doesn't fully fuse during fetal development, depend on the severity of the defect. In mild cases, observation and regular monitoring may be sufficient.

Surgical repair is typically recommended for more significant clefts to improve chest wall stability and prevent potential complications. The surgical techniques vary but often involve closing the gap in the sternum using specialized approaches tailored to each individual case.

Following surgery, patients may require postoperative care and monitoring to ensure proper healing and optimal outcomes. Collaborating closely with a multidisciplinary team, including pediatric surgeons and other specialists, can provide comprehensive care for individuals with sternal cleft.

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