STERNAL CLEFT – REPORT OF THREE CASES
Autori:
Božidar Župančić, Marko Bašković, Andro Gliha, Ljudevit Sović
Sažetak
U posljednjih 25 godina operirali smo troje bolesnika s rascjepom prsne kosti, u dobi od 6 tjedana do dvije godine. Cilj je serije prikazati ovu izrazito rijetku kongenitalnu anomaliju te razlike u operativnom pristupu rascjepu prsne kosti ovisno o dobi bolesnika zbog fleksibilnosti prsnog koša. Bolesnici su se prezentirali znakovima rascjepa prsne kosti, dispozicioniranim sternoklavikularnim zglobovima te paradoksalnim gibanjem kože iznad samog defekta. Preoperativno su učinjeni rendgenogram i kompjutorizirana tomografija prsnog koša koji su pokazali dispozicionirane sternoklavikularne zglobove uz nepotpun rascjep u gornjem dijelu prsne kosti, te ehokardiografija kojom je nađeno ortotropično srce bez malformacija velikih krvnih žila. Kirurško liječenje sastojalo se od primarnog zatvaranja u dojenačkoj dobi, odnosno Sabistonove tehnike primijenjene u dvogodišnje djevojčice. Sve troje bolesnika uspješno je operirano bez komplikacija.
Summary
During the last 25 years we surgically treated three patients with sternal cleft anomaly, aged from 6 weeks to 2 years. The aim of this case series is to present this extremely rare congenital anomaly and differences in the operative treatment of sternal cleft (SC) depending on patients age due to flexibility of the chest wall. Patients presented to us with signs of sternal cleft; displaced sternoclavicular articulations and paradoxical motion of the skin over the defect. Preoperatively we performed X-ray and computed tomography of the chest which revealed displaced sternoclavicular articulations with superior incomplete sternal cleft and echocardiography which showed orthotopic heart without malformations of the great vessels. Surgical treatment included primary closure in two infants and Sabiston’s technique in a two-year-old girl. All three patients were successfully operated without complications.
