Maintenance of Chest Wall Stability

Roux, B. T. Le

doi:10.1136/thx.19.5.397

Cited by 57 publications

(12 citation statements)

References 25 publications

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“…The strut gives stability to the sternum and prevent s parado xical mot ion , especially aft er extensive resection of the costal cartilages. Le R aux (20) reported that those patient s in whom the sternum was not supported, suffered from paradoxical movement which proved an embarrassment in the early postoperative period . Adkins and Gwathmey (3) reported that th e operations performed without the use of a strut gave a very disappointing result with some degree of recurrence of the sternal depression.…”

Section: Discussionmentioning

confidence: 99%

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The Changing Trend in Surgical Reconstruction of Pectus Excavatum

Sv¹

1981

Thorac cardiovasc Surg

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The purpose of this presentation is to review our experience in the correction of pectus excavatum deformity over the past 25 years, to draw attention to some details of importance in securing an excellent end result, and to describe a slight technical modification which improves the cosmetic effect of the surgical procedure. Seventy-five operations were performed between 1951 and 1975 at the North Middlesex Hospital, Regional Cardiothoracic Centre, Edmonton, London, according to the various techniques known during that period. Results were variable until the introduction, 10 years ago, of an operation combining extensive resection of costal-cartilages (34, 35) and stabilization of the sternum (2, 3). Of 37 operations performed during the last 10 years, 35 have given excellent long-term results. The cosmetic results in our hands have been achieved by the use of a stainless steel plate passed beneath the sternum and left in situ for not more than 6 months.

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Section: Discussionmentioning

confidence: 99%

“…Physiological evaluatio n of the deficit has been under take n In pat ient s (31). Kleg and co-wor kers (20) have found a decrease in th e force d expiratory flow and a significant decrease in max imal voluntary ventilation.…”

Section: Introductionmentioning

confidence: 99%

The Changing Trend in Surgical Reconstruction of Pectus Excavatum

Sv¹

1981

Thorac cardiovasc Surg

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“…Many authors recommend rigid internal or external fixation of the sternum (Abrams, 1961;Adkins and Blades, 1961;le Roux, 1964;Moghissi, 1964), others describe stabilization of the corrected sternum with wire struts, (Peters and Johnson, 1964;Johnson, 1972) stainless steel mesh (May, 1961), transsternal fixation with metal struts (Borgeskov and Raahave, 1971), or no fixation at all (Ravitch, 1949 and1965;Lam and Brinkman, 1959). Wooler et al (1969) excised the deformed cartilages, mobilized the sternum, and then sutured the pericardial sac into a central position, which, they believe, corrects the deformity.…”

Section: Clinical Materials and Methodsmentioning

confidence: 99%

Surgical correction of pectus excavatum using a retrosternal bar.

McMillan¹,

Akins²

1975

Thorax

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pectus excavatum using a retrosternal bar. Pectus excavatum is a progressive congenital deformity for which surgical correction is an established procedure.The method of correction using a stainless steel retrosternal bar to maintain the sternum elevated is, in our experience, the most successful procedure. Successful surgical correction usually requires resection of all deformed costal cartilages with transverse osteotomy of the anterior table of the sternum and internal fixation using a bar anterior to the rib cage but behind the sternum.In the last 13 years 118 patients with this deformity have been evaluated and 72 patients have been surgically corrected by the described procedure. Of these 72 patients, 65 (90%) have had excellent or good cosmetic and functional results. The best results were obtained when the child was operated on between the ages of 6 and 10 years, the poorest results in those operated on under the age of 3 or over the age of 20. For a satisfactory result the bar must be left in for at least six months; the best results were obtained in those patients in whom the bar was left in for at least one year. No serious complications have followed the use of this technique.

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“…Clearly, choosing the right materials to replace the sternum is vital. The ideal reconstruction material would meet the following criteria: good hardness and stability to prevent floating of the chest wall; not subject to rejection; suitable for long‐term retention in the body; easily cut, shaped, fixed, and sterilized; and radiopaque. Titanium mesh has been widely used and achieved good results in clinical practice as a repair material for skull defects.…”

Section: Introductionmentioning

confidence: 99%