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Thorac Cardiovasc Surg 2006; 54(1): 57-61
DOI: 10.1055/s-2005-865840
Short Communications

© Georg Thieme Verlag KG Stuttgart · New York

Acquired Deformities of the Anterior Chest Wall

A. A. Fokin1 , F. Robicsek1
  • 1The Department of Thoracic and Cardiovascular Surgery, Heineman Medical Research Laboratories, Carolinas Medical Center, Charlotte, NC, USA
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Publication History

Received April 11, 2005

Publication Date:
17 February 2006 (online)

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Abstract

Background: Acquired chest wall deformities are difficult to describe and to classify. We propose the following classification and treatment options. Methods: We observed 11 patients with acquired deformities (AD) that required surgical correction. Results: AD of the chest can be classified into 4 groups: (1) AD resulting from a pathological process within the thorax (heart enlargement, mediastinal tumors), (2) AD resulting from chest wall disease (rib osteomyelitis or tumors), (3) iatrogenic deformities (following rib graft harvesting, acquired Jeune's syndrome), and (4) post-traumatic deformities. Group 1 requires treatment of the pathological process. Group 2 is guided by oncological or infectious disease principles. Groups 3 and 4 require chest wall reconstruction. Iatrogenic AD usually occur after pectus excavatum repair with rib cartilage extirpation in young patients, which results in a reduced, restricted thorax. Post-traumatic AD often have pathological chest wall mobility owing to pseudo-articulation of injured ribs. Conclusions: To prevent AD formation and to protect thoracic growth and mobility, costosternal and costochondral junctions should be preserved during cartilage resection. Substernal suturing of the perichondrium should be avoided.

Key words

Iatrogenic - post-traumatic - chest wall deformities - pectus excavatum

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MD, PhD Alexander A. Fokin

Carolinas Medical Center

1000 Blythe Blvd.

Charlotte, NC 28203

USA

Phone: + 7043553200

Fax: + 70 43 55 14 35

Email: Alexander.Fokin@carolinashealthcare.org