STERNAL CLEFT (BIFID STERNUM)

A cleft sternum is a rare congenital malformation due to partial or total failure of sternal fusion at an early stage of embryonic development.

This defect occurs due to failure of fusion of the sternal bands at about 8 weeks of gestation.

Hebra and co-workers suggest that clefts are due to extrinsic forces such as adherent aberrant bands.

1. Isolated – cleft starts at the manubrium and extends for a variable distance into the body of the sternum.
1. V-shaped cleft.
2. U-shaped cleft.
3. Cleft extensive and cleft down to the xiphoid.
4. Central perforations in the sternal body and xiphoid fissures.
2. Cleft sternum with associated anomalies.
1. Ectopia cordis.
2. Pentalogy of Cantrell.
3. Cutaneous angiomas.
4. Internal vascular lesions

CLASSIFICATION

Classification based on location of the cleft:

1. Partial (incomplete).

a. V-shaped defect with varying degrees of separation.

i. Superior (usually isolated or associated with vascular dysplasias).

ii. Inferior (usually associated with other severe defects but may be isolated).

b. Sterno-clavicular joints widely separated.

c. Clavicles are usually of normal length.

2. Total (complete)