Abstract
Bone mineral density (BMD) was measured to establish the optimal timing for pectus bar (PB) removal after the Nuss procedure (NP). Twenty-three patients who had PB removal after NP were assessed according to: age at PB insertion/removal, duration of insertion, clinical outcome and BMD. BMD was measured just prior to insertion (in-BMD) and just prior to removal (out-BMD) and %BMD was determined by dividing subject BMD by BMD for age-matched controls. Age at insertion ranged from 4.3-2.7 years and age at removal ranged from 6.3-14.1 years. Duration of insertion ranged from 1.4-3.9 years. There were two cases of recurrence after NP. In these cases, PB insertion occurred at 5 and 4 years, and removal was at 6 and 8 years respectively and both BMD and %BMD were below normal. In the nine cases with no recurrence, PB removal occurred between 6-8 years old; BMD was normal, and %BMD was higher than in the two cases with recurrence. BMD and %BMD would appear to be valuable markers for the timing of PB removal.
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