Abstract
Early in development, driven by mostly unknown factors, a malformed sternum can manifest as a cleft. This is not innocuous, as surgical repair is required to mitigate the deleterious effects of unprotected thoracic organs, impaired respiratory function, and susceptibility to chest infections. We aimed to enrich the literature on this topic by presenting the case of a 10-month-old boy diagnosed with a sternal cleft who underwent reconstruction using a rib cartilage bridging graft supported with fascia and acellular dermal matrix. Management outcomes are expected to improve as surgical approaches evolve from simple primary sternal closure to using cartilaginous or bony grafts and leveraging adjacent soft tissue for added coverage.