Réparation des déformations de la paroi thoracique antérieure : ostéochondroplastie modelante et stabilisation par attelle-agrafe de Borrelly

Abstract

Congenital malformations of the anterior chest wall rarely induce organic clinical symptomatology. The principal indication for surgery is the psychological impact for the young adult. The modelling technique referred as osteochondroplasty with stabilization by sliding splint staplers can be selected in the three following types of deformations: pectus excavatum, pectus carinatum and pectus arcuatum. Such procedure requires good anatomical knowledge of the thoracic malformation because it induces major modifications of the chest resulting from various osteotomies and chondrotomies. These latter interventions are aimed at constructing a real sternochondrocostal shutter which is stabilized afterwards by osteosynthesis using Borrelly’s splint staplers; these staples are positioned, after correction, behind or in front of the breastbone depending on the type of malformation. This technique that requires multidisciplinary management (anaesthetists, thoracic surgeons, plastics surgeons and kinesitherapists) allows obtaining good morphological results, by restitution of normal anatomic properties to the anterior chest wall.