Sternal cleft—a natural absurdity or a surgical opportunity

Sternal cleft is a rare visually dramatic congenital anomaly. It results from failure of fusion of the 2 lateral mesodermal sternal bars by the 8 weeks of gestation. Superior clefts are more frequent than inferior ones, and isolated central clefts are extremely rare. We describe the case of a 4-year-old girl with a central sternal cleft that was closed autogenously with pectoralis major advancement flaps.