Sternal Cleft: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 2, 2026.
What kind of doctor treats Sternal Cleft?
A pediatrician or family doctor usually starts by examining the child and ordering imaging tests. Treatment often involves a pediatric surgeon or a thoracic surgeon. If the heart is involved, a cardiologist joins the care team. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is a sternal cleft?
A sternal cleft is a rare gap in the breastbone, the flat bone at the front of the chest. It happens because the bone does not close fully before birth. Doctors usually find it in babies, though some cases are found later in life.
The breastbone, or sternum, forms during pregnancy when two strips of tissue fuse. When this fusion does not happen, a cleft remains. It can be complete, meaning the whole breastbone is open, or incomplete, meaning only part of it is open.
Symptoms
The main sign is a visible gap or groove in the middle of the chest. In babies, the skin over the gap may bulge with breathing or crying. Some children have frequent lung infections or trouble breathing. Larger clefts leave the heart and lungs with less protection.
Causes and who gets it
Doctors do not always know why the breastbone fails to close. Most cases happen by chance. Some are linked to rare genetic conditions, such as pentalogy of Cantrell. Because it is so uncommon, exact numbers are hard to pin down.
How doctors diagnose it
Doctors can often see a sternal cleft during a physical exam. Imaging tests such as a chest X-ray, CT scan, or MRI confirm it and show how deep the gap is. An echocardiogram checks whether the heart is normal, since heart problems sometimes occur with a sternal cleft.
Treatment
Treatment depends on the size of the gap and the symptoms. Small clefts with no symptoms may only need regular checkups. Larger clefts are usually repaired with surgery, often in infancy, to close the chest wall and protect the heart and lungs.
When to see a doctor
Any baby born with a gap or unusual shape in the chest should be seen soon after birth. Call a doctor if a child with a known chest wall gap has trouble breathing, frequent lung infections, or a chest injury. Sudden chest pain or trouble breathing always needs urgent care.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either type can help coordinate care by ordering imaging, monitoring symptoms, and managing follow-up visits, and will refer the patient to a specialist when needed.
Common questions
Can a sternal cleft be found before birth?
Yes, sometimes. Detailed prenatal ultrasound can show a gap in the chest wall, but smaller clefts may not be seen until after birth.
Is a sternal cleft dangerous?
It depends on the size and whether other problems are present. Large clefts leave the heart less protected and are often repaired early, while small ones may never cause trouble.
Does a sternal cleft always come with heart problems?
No. Many clefts occur alone, but some are part of rare conditions that include heart defects. That is why doctors often check the heart with an echocardiogram.
Can adults have surgery for a sternal cleft?
Yes, repair is possible in adults, though it can be more complex than surgery in infancy. A thoracic surgeon will decide what approach makes sense.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
