PMC8492090_01
On the chest midline, the superior part of the skin which is in front of the heart was fibrotic, and paradoxical respiratory movements were present in this area
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Fig1
On the chest midline, the superior part of the skin which is in front of the heart was fibrotic, and paradoxical respiratory movements were present in this area (Fig. 1).
It is seen that the superior part of the sternum was undeveloped at CT. There were hypoplastic sternal bars bilaterally. Fusion defect of the superior sternum was present, and sternal bars united at the inferior
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Fig2
On three-dimensional thoracic computed tomography (CT), it is seen that the superior part of the sternum was undeveloped (Fig. 2).
A There was a 3-cm opening at the widest part between the sternal bars. B U-shaped defective sternal bars were put in the middle by dissecting from the pleura and pericardium then sutures were placed behind the sternal bars. C The medial periosteum of both sternal bars was dissected and pulled together in front of the pericardium in the midline. D Sternal bars were connected to each other, and the defect was closed completely then the pectoral muscle flaps were put closer in the midline
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Fig3
There was a 3-cm opening at the widest part between the sternal bars (Fig. 3A). U-shaped defective sternal bars were put in the middle by dissecting from the pleura and pericardium. 2/0 polydioxanone sutures (PDS) were placed behind the sternal bars to be approximated later (Fig. 3B). Subsequently, the medial periosteum of both sternal bars was dissected and pull together in front of the pericardium in the midline (Fig. 3C). Earlier prepared pectoral muscle flaps were put closer in the midline in order to support the anterior chest wall (Fig. 3D).
A Fibrotic skin tissue was excised, and the skin was closed. B The first year of the follow-up is uneventful, and sternal bars have not disconnected
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Fig4
Fibrotic skin tissue was excised, and the skin was closed (Fig. 4A). The patient has no problem, and sternal bars have not disconnected (Fig. 4B).