A Comprehensive Review of the Sternal Foramina and its Clinical Significance

A sternal foramen (SF), which arises from the incomplete fusion of the cartilaginous neonatal sternum, is a relatively common anatomical variation found in 2.5% to 13.8 % of all individuals. SFs are usually located at the lower third of the sternal body and their average diameter is 6.5 mm. An SF is subclinical; however, its close proximity to the thoracic organs, i.e., the heart and lungs, entails a risk of serious complications from blinded sternal interventions. Moreover, its presence can lead to misinterpretation of radiological and postmortem findings. The SF is ignored by many physicians and non-physician healthcare providers who must understand its clinical significance in order to optimize patient care. Our aim in this review is to highlight the potential clinical consequences for SF patients, discuss recommendations for performing sternal procedures safely when this anatomical variation is present, and preclude radiological and pathological misinterpretations so that patient care can be improved.