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January 1947


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Arch Surg. 1947;54(1):79-84. doi:10.1001/archsurg.1947.01230070082007

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DEFECTS of the sternum are not common. They may vary from simple notching of the manubrium and irregularities in shape of the xiphoid to complete absence of the entire structure.

The minor defects are not usually recognized and are discovered incidental to a roentgenogram of the chest. The larger defects are brought to attention at birth, because of their effects on the thoracic and mediastinal contents. These effects may be varied, depending on the extent of the defect. Herniation of the lungs will cause decided disturbances of respiration. Lack of normal restraint of the heart and associated large vessels may cause profound circulatory phenomena. This last type of defect attracted my interest, and in studying the literature I was impressed by two facts, namely, (1) the high mortality rate and (2) the attitude of hopelessness on the part of surgical attendants in discussing such cases.

With these facts in mind,

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