Asymmetric Pectus Excavatum Research Articles

Oblique wedge osteotomy for correction of asymmetric pectus excavatum in young children

The procedure modified by Ravitch is usually used to correct pectus excavatum. Young children with asymmetric sternal depression need more modification of the procedure to maintain the sternum in the elevated flat position. In this report we describe a modification of the sternal elevation procedure, including an oblique wedge osteotomy through the anterior table, to correct the asymmetric sternal depression in young children.

Technical Considerations in the Surgical Management of Pectus Excavatum and Carinatum

During the past 25 years, 650 operations have been performed on 608 patients for anatomically significant pectus excavatum or carinatum deformities of the anterior chest wall. There were no deaths in this series, and serious complications were very rare. We conclude that repair of pectus excavatum and carinatum deformities should include the following operative steps: (1) adequate mobilization of the sternum and correction of its abnormal angulation by transverse osteotomy; (2) adequate bilateral removal of the involved costal cartilage; and (3) securing the corrected position of the sternum with the patient's own living tissue, retaining its blood supply and using it as an internal support. Using these principles, new surgical procedures were developed for the correction of: symmetrical pectus excavatum, asymmetrical pectus excavatum, pectus carinatum with xiphoid angulation, pectus carinatum without xiphoid angulation, asymmetrical pectus carinatum, chondromanubrial prominence with chondrogladiolar depression, and recurrent pectus excavatum. We recommend surgical correction for patients in whom the deformity is significant and no contraindication exists. The ill effects of this condition should not be underestimated.