Surgical Repair of Pectus Excavatum and Carinatum
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Keywords:
Sternum
Pectus carinatum
Costal cartilage
Median sternotomy
Sternum
Pectus carinatum
Costal cartilage
Median sternotomy
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Sternum
Pectus carinatum
Thorax (insect anatomy)
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Chest wall deformities are principally depression deformities, the most common being pectus excavatum (funnel chest). The most common protrusion deformity is pectus carinatum (pigeon breast). Pectus carinatum is a cosmetic problem, but its presence can be psychologically devastating to the patient. Pectus excavatum is definitely a physiologic problem, the effects of which may be reversible by surgical correction. Surgery is safe, complications are minimal, and results are usually satisfactory.
Pectus carinatum
Funnel Chest
Sternum
Depression
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Anterior chest wall deformities in children are the expression of some congenital malformation such as Poland's syndrome and pectus excavatum. The surgical treatment of these malformations affecting children is aimed at correcting large wall defects and stabilizing the chest wall, assuring at the same time chest harmonious growth and postoperative functional assessment. We present the results of the treatment of 2 cases of Poland's syndrome, 20 cases of pectus excavatum and 2 cases of pectus carinatum, with a follow-up of 6 months--9 years.
Pectus carinatum
Thoracic wall
Funnel Chest
Congenital malformations
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Pectus carinatum
Nuss Procedure
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Chest wall deformities are principally depression deformities, the most common being pectus excavatum (funnel chest). The most common protrusion deformity is pectus carinatum (pigeon breast). Pectus carinatum is a cosmetic problem, but its presence can be psychologically devastating to the patient. Pectus excavatum is definitely a physiologic problem, the effects of which may be reversible by surgical correction. Surgery is safe, complications are minimal, and results are usually satisfactory.
Pectus carinatum
Funnel Chest
Sternum
Thoracic wall
Depression
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Wenlin chest is a rare complex deformity. It may be misdiagnosed as pectus carinatum or pectus excavatum due to the presence of both protrusion and depression. In the early years, it was just regarded as a kind of pectus carinatum. Considering the operation of this deformity was Ravich procedure, which was also normally used for pectus carinatum, the diagnosis did not affect the treatment. However, once misdiagnosed as pectus excavatum and treated with Nuss procedure, it would be difficult to obtain good results. We met a 22-year-old female Wenlin chest patient recently. She was misdiagnosed as pectus excavatum and underwent Nuss procedure in local hospital 3 years before. Because of no effect, the patient had to come to our hospital for another operation. We performed Wenlin procedure and Wang procedure for her and achieved satisfactory results.
Pectus carinatum
Nuss Procedure
Funnel Chest
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Objective: Pectus excavatum is relatively common congenital chest deformity that is often accompanied by physical and psychological impairment. The surgical methods for pectus excavatum repair are the subject of some controversy. We review our experience using a procedure in which the introduction of exogenous material is unnecessary. Methods: From July 1993 to March 2008, 113 patients underwent surgical repair of pectus excavatum. Sterno-costal elevation was adopted for 102 patients, including all of the paediatric patients and most of the adults. Sternal turnover was employed for 11 adult patients with severe asymmetric deformities. In sterno-costal elevation, a section of the third or fourth to the seventh costal cartilages as well as the lower tip of the sternum below the sixth cartilage junction are resected, and all of the cartilage stumps are re-sutured to the sternum. The secured ribs generate 0.5–10 kg of tension, pulling the sternum bilaterally, such that the resultant force causes the sternum to rise anteriorly. These forces are sufficient to correct the deformities and to prevent flail chest. In sternal turnover, the sternum is cut at the third intercostal space. The lower part of the sternum is turned over and fixed to the upper sternum with an overlap of 1 cm. Sections of the third to the seventh rib cartilages are resected and affixed in the same fashion as in sterno-costal elevation. Results: There were no operative deaths, and in all cases the deformities were corrected satisfactorily. Ninety-nine patients (88%) were graded as Excellent, and the remaining 14 (12%) were graded Good. None of the patients developed any life-threatening complications. No patient reported residual pain. No re-operations were required for any reasons. The patients resumed daily activities of all types, including contact sports, within 3 months after surgery. Conclusions: We believe that morbidity is one of the most important factors to be considered in operative invasions. Our technique represents a less-invasive and lower-risk procedure for the repair of pectus excavatum in any age group.
Sternum
Costal cartilage
Funnel Chest
Thorax (insect anatomy)
Thoracic wall
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Objective:To investigate the effect of elevating stermum on the congenital pectus excavatum.Methods:75 cases of children congenital pectus excavatum were treated by modified traditional Ravitch procedure: elevating sternum stabilized with the steel bar behind sternum and the data of follow-up were retrospectively analyzed.Results:Except two cases of the bar displacement early in postoperation,the operations in other patients were successful with good repair and no complication.66 cases were followed up for 1/2 to 11 years.The chest walls were normal except for 3 cases of slight introcession of anterior chest wall.Conclusions:The children congenital pectus excavatum treated by modified Ravitch procedure showed no complication and good orthopedic effect.
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Pectus carinatum
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