Does early subperichondral removal of several costal cartilages interfere with chest wall growth?

Abstract

The hypothesis that bilateral subperichondral removal of several costal cartilages, as is carried out during the operative correction of anterior chest wall deformities, might interfere with chest wall growth in growing individuals was investigated in an experimental study. Kittens were operated upon at 4 months of age and killed 8 months later. Fifteen animals formed the experimental group and 7 the control group. Chest radiographs were taken under standardized conditions preoperatively and monthly postoperatively until death at 12 months of age. The radiological width and depth of the thorax was measured at the level of the 1sst and 10th thoracic vertebrae. The groups behaved similarly in terms of growth in length and weight gain. The depth of the thorax at the 1 st and 10th thoracic vertebrae and the width at the 10th thoracic vertebra were significantly smaller in the experimental group (P ⩽ 0.001). The differences were already maximal at the first postoperative check and persisted throughout the follow-up period. It is concluded that although bilateral subperichondral removal of several costal cartilages in 4-month-old kittens causes collapse of the anterior chest wall, it does not interfere with chest wall growth. Since the bony ribs comprise a much larger part of the antero-posterior diameter of the chest wall in children than in kittens, it is argued that collapse of the anterior chest wall after a similar operation is much less likely to occur in children.