Madden also mentions several analogous
instances on record. Groux's case was in a person of forty-five,
and the fissure had the vertical length of four inches. Hodgen of
St. Louis reports a case in which there was exstrophy of the
heart through the fissure. Slocum reports the occurrence of a
sternal fissure 3 X 1 1/2 inches in an Irishman of twenty-five.
Madden also cites the case of Abbott in an adult negress and a
mother. Obermeier mentions several cases. Gibson and Malet
describe a presternal fissure uncovering the base of the heart.
Ziemssen, Wrany, and Williams also record congenital fissures of
the sternum.
Thomson has collected 86 cases of thoracic defects and summarizes
his paper by saying that the structures deficient are generally
the hair in the mammary and axillary regions, the subcutaneous
fat over the muscles, nipples, and breasts, the pectorals and
adjacent muscles, the costal cartilages and anterior ends of
ribs, the hand and forearm; he also adds that there may be a
hernia of the lung, not hereditary, but probably due to the
pressure of the arm against the chest. De Marque gives a curious
instance in which the chin and chest were congenitally fastened
together. Muirhead cites an instance in which a firm, broad strip
of cartilage resembling sternomastoid extended from below the
left ear to the left upper corner of the sternum, being entirely
separate from the jaw.
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