Iatrogenic pectus carinatum

Abstract

A boy underwent cardiac surgery when he was 27 months old; prior to that his anterior chest wall had been normal. He later developed a progressive pectus carinatum deformity. Thoracic surgeons are cautioned to be mindful of the sternal and costal growth plates in any surgical approach to intrathoracic structures. Special care is needed when such deformities are corrected in children and adolescents.

Compressive orthotics in the treatment of asymmetric pectus carinatum: A preliminary report with an objective radiographic marker

“…Recently, a nonoperative approach utilizing compressive orthosis was proposed by Haje and Bowen. 3,4 This orthotic, called the dynamic chest compressor (DCC), was constructed with two U-shaped metal rods placed around the patient's chest, 1 anterior and 1 posterior, with an anterior pressure pad and 2 posterior counter-pressure pads. The 2 metal rods were fixed to one another laterally by screws, which could be used to adjust the pressure applied by the pressure pad.…”

“…According to this scale, all patients treated showed improvement, whereas all un-treated patients showed no change or worsening of their deformity. 3,4 We developed a similar nonoperative modality for mild to moderate defects based on compressive orthosis. To objectively quantify the effects of this brace, we developed a radiographic marker to measure initial sternal rotation and subsequent changes with growth or treatment.…”

Nonoperative Correction of Pectus Carinatum with Orthotic Bracing

“…2,3 Acquired etiologies have also been encountered, including drug-induced and poststernotomy. 4,5 The current correction of this condition is surgical, often involving resection of costal cartilages and sternal osteotomy. [6][7][8][9][10][11][12][13][14][15][16] The majority of these operations are variations of the proce-dure first described in 1949 by Ravitch.…”

Abordagem ortopédica das deformidades pectus: 32 anos de estudos

“…Anatomopatologia e formação embriológica do esterno e arcos costais -Muitos autores já utilizaram o termo "suturas" para definir linhas radiotransparentes no esterno em crescimento (5)(6)(7)(8)(9)(10)(11)(12)(13) , mas é importante destacar que suturas existem apenas no crânio e que a formação e o crescimento da parede torácica anterior são endocondrais (14)(15)(16) ; há a presença de placas de crescimento cartilaginosas entre os segmentos do esterno em crescimento e nas junções costocondrais (17)(18)(19)(20)(21)(22) . A formação do esterno ocorre a partir de duas bandas longitudinais de mesoderma, provenientes da região dos ombros, que se unem no sentido craniocaudal à medida que acontece um processo de condrificação.…”