Choice of surgical treatment of pectus excavatum in children based on elasticity criteria of sternocostal complex

This report presents the results of the operative correction of the pectus excavatum in 45 children aged from 5 to 15 years. In relation to the elasticity degree and age of the patients there was performed correction of the pectus excavatum by method of D. Nuss and in modification with application of a metal plate of the own construction. At normal elasticity (degree I) of the anterior sternocostal complex in 22 (48,9%) patients was executed operative intervention by method of D. Nuss, with good result in 21 (95,4%) and satisfactory in 1 (4,5%) patient. At moderate degree of elasticity (II-degree) in 13 (28,9 %) patients procedure of D. Nuss in modification of our clinic was performed. The correction of the pectus excavatum was carried out by chondrotomy of the deformed ribs and placement of the metal plate under the sternocostal complex. The good results were noted in 11 (84,6 %) patients, satisfactory - in 2 (15,4%). At the hypopastic sternocostal complex (degree III) the deformation was removed by Т-shaped or cross sternotomy with chondroresection of some ribs and then placement of the metal plate of D. Nuss under sternocostal complex. The good results were found in 7 (70 %), satisfactory - in 1 (10 %) and unsatisfactory - in 2 (20 %) patients. Thus, the long-term results of treatment depend on the elasticity of sterno-costal complex and the child’s age.

грудная клетка, воронкообразная деформация, эластичность, торакопластика, thorax, pectus excavatum, thoracoplasty