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Special techniques in the keel chest deformity

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Book cover Congenital Thoracic Wall Deformities

Abstract

The etiology of the keel chest deformity, still being a hypothetical explanation and a matter of investigation, is probably caused by secondary elongation of rib cartilages during growth spurts, which result in prominences of the rib themselves or are conjoined with a protrusion of the sternum (Figs. and 2a–c) to a variable extent and shape. Therefore, the surgical correction is aimed at shortening the affected cartilages with or without sternum osteotomies.

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References

  1. Davis JT, Weinstein S (2004) Repair of the pectus deformity: results of the Ravitch approach in the current era. Ann Thorac Surg 78:421–426

    Article  PubMed  Google Scholar 

  2. Fonkalsrud EW, Beanes S (2001) Surgical management of pectus carinatum: 30 years’ experience. World J Surg 25:898–903

    Article  PubMed  CAS  Google Scholar 

  3. Fonkalsrud EW, Anselmo DM (2004) Less extensive techniques for repair of pectus carinatum: the undertreated chest deformity. J Am Coll Surg 198: 898–905

    Article  PubMed  Google Scholar 

  4. Garcia VF, Seyfer AE, Graeber GM (1989) Reconstruction of congenital chest-wall deformities. Surg Clin North Am 69:1103–1118

    PubMed  CAS  Google Scholar 

  5. Haller JA Jr, Colombani PM, Humphries CT, Azizkhan RG, Loughlin GM (1996) Chest wall constriction after too extensive and too early operations for pectus excavatum. Ann Thorac Surg 61: 1618–1624

    Article  PubMed  Google Scholar 

  6. Jeune M, Carron R, Beraud C, Loaec Y (1954) Polychondrodystrophie avec blocage thoracique d’évolution fatale. Pediatrie 9:390–392

    PubMed  CAS  Google Scholar 

  7. Ravitch MM (1960) The operative correction of pectus carinatum (pigeon breast). Ann Surg 151:705–714

    Article  PubMed  CAS  Google Scholar 

  8. Robicsek F, Sanger P, Taylor F, Thomas M (1963) The surgical treatment of chondrosternal prominence (pectus carinatum). J Thorac Cardiovasc Surg 45: 691–701

    PubMed  CAS  Google Scholar 

  9. Robicsek F, Cook JW, Daugherty HK, Selle JG (1979) Pectus carinatum. J Thorac Cardiovasc Surg 78:52–61

    PubMed  CAS  Google Scholar 

  10. Robicsek F (2000) Surgical treatment of pectus carinatum. Chest Surg Clin N Am 10:357–376.

    PubMed  CAS  Google Scholar 

  11. Saxena AK, Willital GH (1999) Surgical repair of pectus carinatum. Int Surg 4:326–330

    Google Scholar 

  12. Schwabegger AH, Harpf C, Ninkovic M, Rieger M (2002) Technical refinements in planning and surgical therapy of pectus carinatum. Chirurg 73:1191–1196

    Article  PubMed  CAS  Google Scholar 

  13. Schwabegger AH, Jeschke J, Schuetz T, Del Frari B (2008) Refinements in pectus carinatum corrections: the pectoralis muscle split technique. J Pediatr Surg 43: 771–774

    Article  PubMed  Google Scholar 

  14. Shamberger RC, Welch KJ (1987) Surgical correction of pectus carinatum. J Pediatr Surg 22:48–53

    Article  PubMed  CAS  Google Scholar 

  15. Welch KJ, Vos A (1973) Surgical correction of pectus carinatum (pigeon breast). J Pediatr Surg 5: 659–667

    Article  Google Scholar 

References

  1. Abramson H, D’Agostino J, Wuscovi S (2008) A 5-year experience with the minimally invasive technique for pectus carinatum repair. J Pediatr Surg 44:118–124

    Article  Google Scholar 

  2. Ashammakhi N, Peltoniemi H, Waris E, Suuronen R, Serlo W, Kellomäki M, Törmölä P, Waris T (2001) Developments in craniomaxillofacial surgery: use of self-reinforced bioabsorbable osteofixation devices. Plast Reconstr Surg 108:167–180

    Article  PubMed  CAS  Google Scholar 

  3. Aszmann OC, Rab M, Kamolz L, Frey M (2000) The anatomy of the pectoral nerves and their significance in brachial plexus reconstruction. J Hand Surg Am 25:942–947

    Article  PubMed  CAS  Google Scholar 

  4. Davis JT, Weinstein S (2004) Repair of the pectus deformity: results of the Ravitch approach in the current era. Ann Thorac Surg 78:421–426

    Article  PubMed  Google Scholar 

  5. Eppley BL (2005) Use of resorbable plates and screws in pediatric facial fractures. J Oral Maxillofac Surg 63:385–391

    Article  PubMed  Google Scholar 

  6. Fonkalsrud EW, Anselmo DM (2004) Less extensive techniques for repair of pectus carinatum: the under-treated chest deformity. J Am Coll Surg 198:898–905

    Article  PubMed  Google Scholar 

  7. Fonkalsrud EW, Beanes S (2001) Surgical management of pectus carinatum: 30 years’ experience. World J Surg 25:898–903

    Article  PubMed  CAS  Google Scholar 

  8. Garcia VF, Seyfer AE, Graeber GM (1989) Reconstruction of congenital chest-wall deformities. Surg Clin North Am 69:1103–1118

    PubMed  CAS  Google Scholar 

  9. Gürkök S, Genc O, Dakak M, Balkanli K (2001) The use of absorbable material in correction of pectus deformities. Eur J Cardiothorac Surg 19:711–712

    Article  PubMed  Google Scholar 

  10. Haje SA, Bowen JR (1992) Preliminary results of orthotic treatment of pectus deformities in children and adolescents. J Pediatr Orthop 12:795–800

    Article  PubMed  CAS  Google Scholar 

  11. Jensen NK, Schmidt WR, Garamella J, Lynch MF (1970) Pectus excavatum: the how, when and why of surgical correction. J Pediatr Surg 5:4–13

    Article  PubMed  CAS  Google Scholar 

  12. Kellomäki M, Niiranen H, Puumanen K, Ashammakhi N, Waris T, Törmälä P (2000) Bioabsorbable scaffolds for guided bone regeneration and generation. Biomaterials 21:2495–2505

    Article  PubMed  Google Scholar 

  13. Kravarusic D, Dicken BJ, Dewar R, Harder J, Poncet P, Schneider M, Sigalet DL (2006) The Calgary protocol for bracing of pectus carinatum. J Pediatr Surg 41:923–926

    Article  PubMed  Google Scholar 

  14. Luzzi L, Voltolini L, Zacharias J, Campione A, Ghiribelli C, Di Bisceglie M, Gotti G (2004) Ten year experience of bioabsorbable mesh support in pectus excavatum repair. Br J Plast Surg 57:733–740

    Article  PubMed  CAS  Google Scholar 

  15. Manktelow RT, McKee NH, Vettese T (1980) An anatomical study of the pectoralis major muscle as related to functioning free muscle transplantation. Plast Reconstr Surg 65:610–615

    Article  PubMed  CAS  Google Scholar 

  16. Matsui T, Kitano M, Nakanuro T, Shimigu Y, Hyon SH, Ikado Y (1994) Bioabsorbable struts made from poly L-lactide and their application for treatment of chest deformity. J Thorac Cardiovasc Surg 108:162–168

    PubMed  CAS  Google Scholar 

  17. Mayberry JC, Terhes JT, Ellis TJ, Wanek S, Mullins RJ (2003) Absorbable plates for rib fracture repair: preliminary experience. J Trauma 55:835–839

    Article  PubMed  Google Scholar 

  18. Morain WD, Colen LB, Hutchings JC (1985) The segmental pectoralis major flap: a function-preserving procedure. Plast Reconstr Surg 75:825–830

    Article  PubMed  CAS  Google Scholar 

  19. Ravitch MM (1960) The operative correction of pectus carinatum (pigeon breast). Ann Surg 151:705–714

    Article  PubMed  CAS  Google Scholar 

  20. Robicsek F (2000) Surgical treatment of pectus carinatum. Chest Surg Clin North Am 10:357–376

    CAS  Google Scholar 

  21. Robicsek F, Sanger P, Taylor F, Thomas M (1963) The surgical treatment of chondrosternal prominence (pectus carinatum). J Thorac Cardiovasc Surg 45: 691–701

    PubMed  CAS  Google Scholar 

  22. Robicsek F, Cook JW, Daugherty HK, Selle JG (1979) Pectus carinatum. J Thorac Cardiovasc Surg 78:52–61

    PubMed  CAS  Google Scholar 

  23. Schoenmakers M, Gulmans V, Bax N, Helders P (2000) Physiotherapy as an adjuvant to the surgical treatment of anterior chest wall deformities: a necessity? A prospective descriptive study in 21 patients. J Pediatr Surg 35:1440–1443

    Article  PubMed  CAS  Google Scholar 

  24. Schwabegger AH, Harpf C Ninkovic M, Rieger M (2002) Technical refinements in planning and surgical therapy of pectus carinatum. Chirurg 73:1191–1196

    Article  PubMed  CAS  Google Scholar 

  25. Schwabegger AH, Jeschke J, Schuetz T, Del Frari B (2008) Refinements in pectus carinatum corrections: the pectoralis muscle split technique. J Pediatr Surg 43:771–774

    Article  PubMed  Google Scholar 

  26. Shamberger RC, Welch KJ (1987) Surgical correction of pectus carinatum. J Pediatr Surg 22:48–53

    Article  PubMed  CAS  Google Scholar 

  27. Stephenson JT, Du Bois J (2008) Compressive orthotic bracing in the treatment of pectus carinatum: the use of radiographic markers to predict success. J Pediatr Surg 43:1776–1780

    Article  PubMed  Google Scholar 

  28. Tobin GR (1985) Pectoralis major segmental anatomy and segmentally split pectoralis major flaps. Plast Reconstr Surg 75:814–824

    Article  PubMed  CAS  Google Scholar 

  29. Wolfram D, Tzankov A, Pülzl P, Piza-Katzer H (2009) Hypertrophic scars and keloids — a review of their pathophysiology, risk factors and therapeutic management. Dermatol Surg 35:171–181

    Article  PubMed  CAS  Google Scholar 

References

References

  1. Alster TS, Tanzi EL (2003) Hypertrophic scars and keloids: etiology and management. Am J Clin Dermatol 4:235–243

    Article  PubMed  Google Scholar 

  2. Carr-Collins JA (1992) Pressure techniques for the prevention of hypertrophic scars. Clin Plast Surg 19: 733–743

    PubMed  CAS  Google Scholar 

  3. Chan KY, Lau CL, Adeeb SM, Somasundaram S, Nasir-Zahari M (2005) A randomized, placebo-controlled, double-blind, prospective clinical trial of silicone gel in prevention of hypertrophic scar development in median sternotomy wound. Plast Reconstr Surg 116: 1013–1020

    Article  PubMed  CAS  Google Scholar 

  4. Egan JC, DuBois JJ, Morphy M, Samples TL, Lindell B (2000) Compressive orthotics in the treatment of asymmetric pectus carinatum: a preliminary report with an objective radiographic marker. J Pediatr Surg 35: 1183–1186

    Article  PubMed  CAS  Google Scholar 

  5. O’Brien L, Pandit A (2006) Silicon gel sheeting for preventing and treating hypertrophic and keloid scars. Cochrane Database Syst Rev 25:CD003826

    Google Scholar 

  6. Mielke CH, Winter RB (1993) Pectus carinatum successfully treated with bracing. A case report. Int Orthop 17: 350–352

    Article  PubMed  CAS  Google Scholar 

  7. Schwabegger AH, Harpf C, Ninkovic M, Rieger, M (2002) Technische Neuerungen in der Planung und Therapie der Kielbrust-Deformität. Chirurg 73:1191–1196

    Article  PubMed  CAS  Google Scholar 

  8. Schwabegger AH, Jeschke J, Schütz T, Del Frari B (2008) Refinements in pectus carinatum correction: the pectoralis muscle split technique. J Pediatr Surg 43:771–774

    Article  PubMed  Google Scholar 

  9. Ziegler UE (2004) Internationale Klinische Empfehlungen zur Narbenbehandlung (International Clinical Recommendations on Scar Management) Zentralbl Chir 129:296–306

    CAS  Google Scholar 

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Schwabegger, A.H., Del Frari, B. (2011). Special techniques in the keel chest deformity. In: Schwabegger, A.H. (eds) Congenital Thoracic Wall Deformities. Springer, Vienna. https://doi.org/10.1007/978-3-211-99138-1_7

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  • DOI: https://doi.org/10.1007/978-3-211-99138-1_7

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-211-99137-4

  • Online ISBN: 978-3-211-99138-1

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