Thoracic Skeleton Research Articles

Differential Growth and Development of the Upper and Lower Human Thorax

The difficulties in quantifying the 3D form and spatial relationships of the skeletal components of the ribcage present a barrier to studies of the growth of the thoracic skeleton. Thus, most studies to date have relied on traditional measurements such as distances and indices from single or few ribs. It is currently known that adult-like thoracic shape is achieved early, by the end of the second postnatal year, with the circular cross-section of the newborn thorax transforming into the ovoid shape of adults; and that the ribs become inclined such that their anterior borders come to lie inferior to their posterior. Here we present a study that revisits growth changes using geometric morphometrics applied to extensive landmark data taken from the ribcage. We digitized 402 (semi) landmarks on 3D reconstructions to assess growth changes in 27 computed tomography-scanned modern humans representing newborns to adults of both sexes. Our analyses show a curved ontogenetic trajectory, resulting from different ontogenetic growth allometries of upper and lower thoracic units. Adult thoracic morphology is achieved later than predicted, by diverse modifications in different anatomical regions during different ontogenetic stages. Besides a marked increase in antero-posterior dimensions, there is an increase in medio-lateral dimensions of the upper thorax, relative to the lower thorax. This transforms the pyramidal infant thorax into the barrel-shaped one of adults. Rib descent is produced by complex changes in 3D curvature. Developmental differences between upper and lower thoracic regions relate to differential timings and rates of maturation of the respiratory and digestive systems, the spine and the locomotor system. Our findings are relevant to understanding how changes in the relative rates of growth of these systems and structures impacted on the development and evolution of modern human body shape.

Comparison of distribution characteristics of metastatic bone lesions between breast and prostate carcinomas

The purpose of the present study was to investigate the distribution characteristics of bone metastases in breast and prostate carcinomas. Bone scintigraphies were performed in 504 cancer patients. We studied the correlation between the distribution and total number of metastatic bone lesions, and compared the distribution of metastatic bone lesions between breast and prostate carcinomas. In the early stage, the distribution in the thoracic vertebrae, lumbar vertebrae and pelvis of the metastatic lesions of the prostate carcinoma (81.0%, 47/58) was significantly higher than that of the breast carcinoma (41.7%, 63/151; χ(2)=27.6, P=0.000). The distribution of the lesions in the thoracic skeleton in the cases of the breast carcinoma (65.6%, 99/151) was significantly higher than that of the prostate carcinoma (27.6%, 16/58; χ(2)=24.8, P=0.000); however, the distributions in the advanced cases were not markedly different. The differences in the proportions of the metastatic lesions in the lumbar vertebrae (χ(2)=56.1, P=0.000) and ribs (χ(2)=39.1, P=0.000) in the cases of the prostate carcinoma, and in the sternum (χ(2)=31.2, P=0.000), skull (χ(2)=26.5, P=0.000) and femur (χ(2)=13.6, P=0.001) in the cases of the breast carcinoma were significant. Between the breast and prostate carcinomas, the differences in the proportions of the metastatic lesions of certain bones were also significant. In cases with few bone metastases, the proportion of sternum metastases of patients with breast carcinoma (17.9%) was significantly higher than that of patients with prostate carcinoma (1.7%; χ(2)=12.7, P=0.000); the proportion of metastases in the lumbar vertebrae of prostate carcinoma (39.7%) was significantly higher than that of breast carcinoma (13.9%; χ(2)=15.4, P=0.000); the proportion of rib metastases of breast carcinoma (27.2%) was significantly higher than that of prostate carcinoma (8.6%; χ(2)=9.6, P=0.002). In cases with extensive bone metastases, the proportions of metastatic lesions in the sternum and lumbar vertebrae in breast and prostate carcinomas were not significantly different (P>0.05). In conclusion, the distribution of bone metastases is correlated with the total number of metastatic bone lesions in breast and prostate carcinoma patients, and has different characteristics in different lesions.

Straightened Sternal Wire Causes Iatrogenic Pectus Carinatum After Cardiac Surgery

Pectus carinatum is a protrusion deformity of the anterior chest wall that is most likely caused by a disproportionate growth of the costal cartilages compared with the remainder of the thoracic skeleton. A young boy had previously undergone corrective congenital heart operation, after which a prominent sternal protrusion was noted. During the past year, the protrusion had greatly increased in size and had become recurrently infected. Chest X-ray showed that a sternal wire, the ends of which were pointing toward the skin, had straightened. Operative intervention included removal of the offending wire, draining a chronic abscess, and shaving the protruding sternum so that it conformed to the rest of the sternum.

Morphometric sex determination from various sternal widths of Northwest Indian sternums collected from autopsy cadavers: A comparison of sexing methods

The sternum is one of the least studied bones of human thoracic skeleton for sex determination both in forensic anthropology as well as in archeology. In the present study, the relationship between various sternal widths and known sex of the deceased was studied in a sample of 343 adult human sternums based on anthropometric measurements. A comparison was also made with different widely used methods of sex determination. The sternubrial width index was found to be the poorest indicator of sex, whereas all the other variables were equally suitable for sex determination. The criteria of demarking points (calculated from mean±3SD) failed in sex determination of the studied sternums. The identification points correctly sexed more percentage of bones than the demarking points which are considered more reliable covering more than 99.67% of cases. The limiting points proved to be a best method for almost all the variables, sexing about 70–80% of the sternums examined for this purpose. The multivariate discriminant function analysis (DFA) of various sternal widths correctly sexed 84% sternums (Males=82.1%, Females=89%). The sex of a sternum of Northwest India can be estimated using equation F (D)=−13.166+0.087 BB-1+0.088 BB-2+0.150 BB-4+0.040 MBX+0174 WS-1 (group centroids i.e., 0.508 for male and −1.408 for female). From the logistic regression analysis, 86.6% sternums (93.3% males and 68.1% females) were assigned the correct sex category, thus giving slightly better results than DFA. Comparatively more males were correctly sexed than females using almost all the criteria except DFA. In conclusion, regression analysis was found the best statistical method of sex determination from various sternal widths studied in the present study.

Fallstricke in der radiologischen Diagnostik und Begutachtung der benignen asbestbedingten Erkrankungen des Thorax

The recognition of asbestos-related diseases of the lung and/or pleura as an occupational disease is of psychosocial, medical and legal importance to the insured person. Radiological imaging is an essential part of the assessment and requires an increasingly high level of competence in the field of radiological diagnosis of pneumoconiosis in interdisciplinary collaboration with occupational medicine and pneumonology. The chest radiogram remains an integral part of basic diagnostic procedures in asbestos-related diseases of the lungs and/or pleura. Its importance lies in the detection of extended pleural changes as well as substantial fibrosis. The inherent low sensitivity and specificity of projection radiography is taken into account by the increasing use of multi-slice high resolution (HR) CT (in low dose technique). Radiological pitfalls in pleural plaque assessment with respect to plain chest X-ray concern all structures that superimpose on the pleural circumference, particularly the anatomical layers of the chest wall (extra-pleural fatty tissue, muscles, thoracic skeleton) as well as other pulmonary findings that can only be reliably assigned using CT. Even if state-of the-art CT is applied, asymmetries and abnormal expression of anatomical structures and variants (e. g. muscles and blood vessels) can lead to false-positive findings. The interstitial fibrosis of asbestosis, manifested as usual interstitial pneumonia (UIP) is non-pathognomonic for asbestosis. Therefore, parietal pleural thickening as a coincident finding to UIP is considered as being the main feature and a highly suggestive indicator of asbestosis in patients with a history of asbestos exposure.

Antibody Labelling of Resilin in Energy Stores for Jumping in Plant Sucking Insects

The rubbery protein resilin appears to form an integral part of the energy storage structures that enable many insects to jump by using a catapult mechanism. In plant sucking bugs that jump (Hemiptera, Auchenorrhyncha), the energy generated by the slow contractions of huge thoracic jumping muscles is stored by bending composite bow-shaped parts of the internal thoracic skeleton. Sudden recoil of these bows powers the rapid and simultaneous movements of both hind legs that in turn propel a jump. Until now, identification of resilin at these storage sites has depended exclusively upon characteristics that may not be specific: its fluorescence when illuminated with specific wavelengths of ultraviolet (UV) light and extinction of that fluorescence at low pH. To consolidate identification we have labelled the cuticular structures involved with an antibody raised against a product of the Drosophila CG15920 gene. This encodes pro-resilin, the first exon of which was expressed in E. coli and used to raise the antibody. We show that in frozen sections from two species, the antibody labels precisely those parts of the metathoracic energy stores that fluoresce under UV illumination. The presence of resilin in these insects is thus now further supported by a molecular criterion that is immunohistochemically specific.

The costal skeleton of Homo antecessor: preliminary results

The Lower Pleistocene TD6 level at the Gran Dolina site in the Sierra de Atapuerca (Burgos, Spain) has yielded nine ribs that represent a minimum of three individuals of the species, Homo antecessor. We present a detailed morphological and metric study of these costal elements, including the siding and anatomical position of all of the rib remains. The adult or nearly adult ribs are also metrically compared with other fossil hominins and with modern comparative samples. The costal elements recovered to date from the TD6 level at Gran Dolina can neither confirm nor reject the hypothesis that H. antecessor had a large thorax, similar to that of Neandertals. However, the fragmentary evidence of the H. antecessor thoracic skeleton is not inconsistent with this suggestion based on other skeletal elements, such as clavicles. Resumen En el nivel TD6 del Pleistoceno inferior del yacimiento de Gran Dolina, en la Sierra de Atapuerca (Burgos, España) se han recuperado nueve costillas que pertenecen a un mínimo de tres individuos de la especie Homo antecessor. Presentamos un detallado estudio métrico y morfológico incluyendo el lado y la determinación anatómica. Las costillas pertenecientes a individuos adultos o casi adultos también son comparadas métricamente a muestras modernas de comparación y otros homininos fósiles. Basándonos en el registro de costillas de Homo antecessor recuperado hasta el momento no podemos probar ni refutar la hipótesis de que esta especie presentaba un tórax grande similar al de los Neandertales. Sin embargo, el registro de costillas no es inconsistente con la hipótesis de un tórax grande como sugiere la gran longitud de sus clavículas.

A second new species of ice crawlers from China (Insecta: Grylloblattodea), with thorax evolution and the prediction of potential distribution.

Modern grylloblattids are one of the least diverse of the modern insect orders. The thorax changes in morphology might be associated with the changes of the function of the forelegs, wing loss, changes in behavior and adaptation to habitat. As temperature is the main barrier for migration of modern grylloblattids, the range of each species is extremely limited. The potential distribution areas of grylloblattids remain unclear. A second new species of ice crawlers (Insecta: Grylloblattodea), Grylloblattella cheni Bai, Wang et Yang sp. nov., is described from China. The distribution map and key to species of Grylloblattella are given. A comparison of the thorax of extant and extinct Grylloblattodea is presented, with an emphasis on the pronotum using geometric morphometric analysis, which may reflect thorax adaptation and the evolution of Grylloblattodea. Potential global distribution of grylloblattids is inferred. Highly diversified pronota of extinct Grylloblattodea may reflect diverse habitats and niches. The relatively homogeneous pronota of modern grylloblattids might be explained by two hypotheses: synapomorphy or convergent evolution. Most fossils of Grylloblattodea contain an obviously longer meso- and metathorax than prothorax. The length of the meso- and metathorax of modern grylloblattids is normally shorter than the prothorax. This may be associated with the wing loss, which is accompanied by muscle reduction and changes to the thoracic skeleton system. Threats to grylloblattids and several conservation comments are also provided.

Convergences in the diversification of bats

Abstract Twenty-five characters or suites of characters from bats are considered in light of changes in bat classification. The characters include some associated with flower-visiting (two), echolocation (12), roosting (six), reproduction (two) and three are of unknown adaptive function. In both the 1998 and 2006 classifications of bats into suborders (Megachiroptera and Microchiroptera versus Yinpterochiroptera and Yangochiroptera, respectively), some convergences between suborders are the same (e.g., foliage roosting, tent building), but others associated with echolocation differ substantially. In the 1998 phylogeny convergences associated with echolocation (high duty cycle echolocation, nasal emission of echolocation calls) occurred among the Microchiroptera. In the 2006 phylogeny, they occur between Yinpterochiroptera and Yangochiroptera. While some traits apparently arose independently in two suborders (e.g., foliage-roosting, tent building, low intensity echolocation calls, noseleafs, nasal emission of echolocation calls, high duty cycle echolocation behaviour), others appear to have been ancestral (roosting in narrow spaces, laryngeal echolocation, stylohyal-tympanic contact, oral emission of echolocation calls, and small litter size). A narrow profile through the chest is typical of bats reflecting the thoracic skeleton. This feature suggests that the ancestors of bats spent the day in small crevices. Features associated with laryngeal echolocation appear to be ancestral, suggesting that echolocation evolved early in bats but was subsequently lost in one yinpterochiropteran lineage.

METHODS OF STABILIZING THE THORACIC SKELETON IN CASES OF FLOATING RIBS FRACTURES AND THERE COMPLICATIONS

The effectiveness of different methods of stabilizing thoracic skeleton in cases of floating and complicated fractures of ribs in 58 patients has been studied. The usage of combined methods of stabilizing bone fragments has been substantiated. A new surgical procedure is proposed.

Scoliosis Model Created by Pedicle Screw Tethering in Immature Goats

An in vivo model of scoliosis was established in immature goats. To assess the feasibility, reliability, and complications of the innovative animal model. Among the methods of creating a scoliotic model, posterior asymmetric tethering of spine yielded encouraging results. However, some shortcomings associated with the use of posterior asymmetric tether are apparent. Fourteen female goats (age: 5-8 weeks old, weight: 6-8 kg), were instrumented and tethered using unilateral pedicle screws and contralateral rib resections. Twelve of the goats were followed up for 8 weeks by serial radiography. Six goats were removed of the posterior load and no treatment was given. Two goats were selected randomly from the 6 animals and subjected to computed tomography (CT) three-dimensional reconstruction after another 8 weeks. All the 6 goats were killed and spine specimens were harvested for histologic study 16 weeks after observation. Radiographic observation showed that 12 goats developed scoliosis with convex toward the right side, and the curvature increased with time in 11 goats, and it remained unchanged in 1 animal. The angle immediately after the procedures averaged 29.0 degrees (23 degrees -38 degrees ) and increased to an average of 43.0 degrees (36.0 degrees -58.0 degrees ) over a period of 8 to 10 weeks, with average angle increment being 14.0 degrees (P < 0.001). The curvature ceased to increase in 6 goats during the subsequent 2 months after the tether were removed (P > 0.05). Three-dimensional CT reconstruction revealed that the vertebral bodies were wedged, the 2 sides of the thoracic skeleton were asymmetric, and the vertebrae in the major curve were rotated. Histologic study revealed that the goats remained in growth stage and the growth potential of 2 sides of the spine was not identical. Radiography and three-dimensional CT reconstruction of vertebrae revealed that the architectural alterations found in the model were similar to those of idiopathic-type deformity observed in clinical practice.

Skeletal histology of Bothriolepis canadensis (Placodermi, Antiarchi) and evolution of the skeleton at the origin of jawed vertebrates

We used light microscopy and scanning electron microscopy to compile a complete histological description of the dermal skeleton of the antiarch placoderm, Bothriolepis canadensis. Placodermi is most often cited as the sister group of crown group Gnathostomata, but some recent authors propose that placoderms instead represent a paraphyly of forms leading to the crown. In either phylogenetic scenario, comparative analysis of placoderm and gnathostome histological data allows us to address the primitive condition of both the gnathostome skeleton and the jawed vertebrate skeleton. The results of this work support the interpretation that the external skeleton of Bothriolepis canadensis is comprised exclusively of cellular dermal bone tissue. The unique stratification of the antiarch thoracic skeleton that has led to controversial interpretations in the past is explained by the nature of the articulations between adjacent elements. Skeletal features long thought to be gnathostome innovations are instead discovered to arise along the gnathostome stem. These innovations include secondary osteons, the systematic reconstruction of the skeleton in response to growth, and unfused, overlapping joints that enable marginal growth while maximizing the area of the articulation surface. The extensive evidence for spheritic mineralization agrees with a model of the skeleton as one capable of a high growth rate and active remodeling. Dermal skeletal development in both placoderms and osteichthyans is primarily skeletogenetic with only a minor odontogenetic contribution in some taxa. This demonstrates the problem inherent with assuming a broad application for those hypotheses of dermal skeletal evolution that are based on a chondrichthyan model. Our results highlight the importance of anatomical and ontogenetic context in the interpretation of fossil tissues.

Corrections in Dose Assessment of99mTc Radiolabeled Aerosol Particles Targeted to Central Human Airways Using Planar Gamma Camera Imaging

The dose of inhaled radiolabeled aerosols is usually assessed using gamma (GC) camera imaging. Because of the complex and inhomogeneous structure of the lung, consisting of soft tissue, the thoracic skeleton, blood vessels, and air spaces, proper attenuation correction coefficients are difficult to evaluate and the estimated doses bear high uncertainty. One hundred milliliters of aerosol boli composed of 100 nm diameter (99m)Tc radiolabeled carbon particles (Technegas) were targeted either to the airways (AW) or to 800-mL volumetric lung depth (alveoli, AL) in 11 healthy volunteers. In addition, 750-mL full breaths (FB) of aerosol were inhaled to a 800-mL lung depth. The deposited dose was measured by collecting aerosol from inhaled and exhaled air stream on filters, which were analyzed for radioactivity. Lung imaging was performed using a planar GC (posterior). Ratios of GC counts to deposited dose (GC/DD) were similar after FB and AL administration, but twofold lower after AW administration (p < 0.01). Associated attenuation correction factors (ACF) were 2.5 +/- 0.5 (FB), 2.2 +/- 0.4 (AL), and 5.5 +/- 1.6 (AW, p < 0.01). Both GC/DD and ACF were highly correlated to the aerosol distribution index (central to peripheral ratio, C/P). After shallow bolus administration there was a negative correlation between body mass index and GC/DD. Inhalation of radioaerosols used in medical diagnosis and therapy in combination with high central airway deposition results in an underestimation of the deposited dose based on planar GC imaging. The aerosol distribution index C/P may provide one suitable indicator for corrections, which should be confirmed in future studies by individual attenuation analysis based on radiotracer transmission measurements.

The thoracic morphology of Archostemata and the relationships of the extant suborders of Coleoptera (Hexapoda).

Thoracic structures of Tetraphalerus bruchi are described in detail. The results were compared with features found in other representatives of Archostemata and other coleopteran suborders. Differences between thoracic structures of Tetraphalerus and members of other archostematan subgroups are discussed. External and internal characters of larval and adult representatives of 37 genera of the coleopteran suborders are outlined, coded and analysed cladistically, with four groups of Neuropterida as outgroup taxa. The results strongly suggest the branching pattern Archostemata + [Adephaga + (Myxophaga + Polyphaga)]. Coleoptera excluding Archostemata are supported with a high Bremer support. Important evolutionary changes linked with this branching event are simplifications of the thoracic skeleton resulting in reduced degrees of freedom (i.e. a restricted movability, especially at the leg bases), and a distinct simplification of the muscle system. This development culminates in Polyphaga, which are also strongly supported as a clade. Internalization of the partly reduced propleura, further muscle losses, and the fusion of the mesoventrites and metaventrites-with reversal in Scirtoidea and Derodontidae-are autapomorphies of Polyphaga. Archostemata is a small relict group in contrast to highly successful xylobiontic groups of Polyphaga. The less efficient thoracic locomotor apparatus, the lack of cryptonephric Malpighian tubules, and the rise of angiosperms with beetle groups primarily adjusted to them may have contributed to the decline of Archostemata. © The Willi Hennig Society 2008.

Sonographic development of the normal foetal thorax and abdomen across gestation

In the following review, the development of the thorax and abdomen, as described by embryologists and anatomists in modern embryological text books, is compared with sonoanatomic descriptions from 2D and 3D ultrasound studies, week by week in the first trimester. The anatomic descriptions are limited to details that are of interest for the understanding of ultrasound examinations. For the second and third trimester, the description of the sonographic development of the thorax and abdomen is divided into thoracic skeleton, diaphragm, lungs, oesophagus, stomach, liver, spleen, bowel and gall bladder. The review is restricted to the normal development, appearance and biometric assessment of these organs; and discusses topical literature.

A normalized thoracic coordinate system for atlas mapping in 3D CT images

In this paper, a normalized thoracic coordinate system (NTCS) is defined for rapidly mapping the 4D thoracic organ atlas into individual CT volume images. This coordinate system is defined based on the thoracic skeleton. The coordinate values are normalized by the size of the individual thorax so that this coordinate system is universal to different individuals. For compensating the respiratory motion of the organs, a 4D dynamic torso atlas is introduced. A method for mapping this dynamic atlas into the individual image using the NTCS is also proposed. With this method, the dynamic atlas was mapped into the clinical thoracic CT images and rough positions of the organs were found rapidly. This NTCS-based 4D atlas mapping method may provide a novel way for estimating the thoracic organ positions in low-resolution molecular imaging modalities, as well as in modern 4D medical images.

Hox patterning of the vertebrate rib cage

Unlike the rest of the axial skeleton, which develops solely from somitic mesoderm, patterning of the rib cage is complicated by its derivation from two distinct tissues. The thoracic skeleton is derived from both somitic mesoderm, which forms the vertebral bodies and ribs, and from lateral plate mesoderm, which forms the sternum. By generating mouse mutants in Hox5, Hox6 and Hox9 paralogous group genes, along with a dissection of the Hox10 and Hox11 group mutants, several important conclusions regarding the nature of the ;Hox code' in rib cage and axial skeleton development are revealed. First, axial patterning is consistently coded by the unique and redundant functions of Hox paralogous groups throughout the axial skeleton. Loss of paralogous function leads to anterior homeotic transformations of colinear regions throughout the somite-derived axial skeleton. In the thoracic region, Hox genes pattern the lateral plate-derived sternum in a non-colinear manner, independent from the patterning of the somite-derived vertebrae and vertebral ribs. Finally, between adjacent sets of paralogous mutants, the regions of vertebral phenotypes overlap considerably; however, each paralogous group imparts unique morphologies within these regions. In all cases examined, the next-most posterior Hox paralogous group does not prevent the function of the more-anterior Hox group in axial patterning. Thus, the ;Hox code' in somitic mesoderm is the result of the distinct, graded effects of two or more Hox paralogous groups functioning in any anteroposterior location.

Thoracic skeletal morphology and high‐altitude hypoxia in Andean prehistory

Living humans from the highland Andes exhibit antero-posteriorly and medio-laterally enlarged chests in response to high-altitude hypoxia. This study hypothesizes that morphological responses to high-altitude hypoxia should also be evident in pre-Contact Andean groups. Thoracic skeletal morphology in four groups of human skeletons (N = 347) are compared: two groups from coastal regions (Ancón, Peru, n = 79 and Arica, Chile, n = 123) and two groups from high altitudes (San Pedro de Atacama, Chile, n = 102 and Machu Picchu and Cuzco, Peru, n = 43). Osteometric variables that represent proportions of chest width and depth include sternal and clavicular lengths and breadths and rib length, curvature, and area. Each variable was measured relative to body size, transformed into logarithmic indices, and compared across sex-specific groups using ANOVA and Tukey multiple comparison tests. Atacama highlanders have the largest sternal and clavicular proportions and ribs with the greatest area and least amount of curvature, features that suggest an antero-posteriorly deep and mediolaterally wide thoracic skeleton. Ancón lowlanders exhibit proportions indicating narrower and shallower chests. Machu Picchu and Cuzco males cluster with the other highland group in rib curvature and area at the superior levels of the thorax, whereas chest proportions in Machu Picchu and Cuzco females resemble those of lowlanders. The variation in Machu Picchu and Cuzco males and females is interpreted as the result of population migrations. The presence of morphological traits indicative of enlarged chests in some highland individuals suggests that high-altitude hypoxia was an environmental stressor shaping the biology of highland Andean groups during the pre-Contact period.

Die Rekonstruktion eines zertrümmerten Brustskeletts mithilfe des Implantats HI-TEX®PARP NT

The authors present the case of a 57-year-old man with polytrauma, who was injured in a train accident. Together with other injuries, he also sustained multiple comminuted fractures on the left half of the rib cage. These subsequently required surgical intervention because of thoracic instability and impending lung injury. Extensive damage to the thoracic skeleton was treated by removal of the damaged tissues and replacement by the HI-TEX PARP NT implant. The presented procedure is being discussed as an alternative to metallic fixation in thoracic instability in cases of devastating injury or injury resulting in bone and tissue loss.

Intravenous ketoprofen as an adjunct to patient-controlled analgesia morphine in adolescents with thoracic surgery: A placebo controlled double-blinded study

Background Surgery to correct pectus deformities entail substantial destruction of the thoracic skeleton and thus may cause significant postoperative pain. Aims To evaluate the efficacy of intravenous ketoprofen, a NSAID, as an adjunct to PCA morphine in pain treatment in children having pectus surgery. Methods Thirty-one children aged 10–15 years completed the study according to protocol. Children ( n = 14) in the ketoprofen-group received ketoprofen 1 mg/kg i.v. at the skin closure, and at 8 and 16 h after surgery, while children ( n = 17) in the placebo-group received normal saline, respectively. For rescue analgesia the patient had an access to PCA-morphine. The children expressed their pain by a coloured VAS. Results Mean cumulative 24 h morphine dose used was less in the ketoprofen-group (mean ± SD: 490 ± 240 μg/kg) than in the placebo-group (670 ± 200 μg/kg) (mean difference 180 μg/kg, 95% CI for diff: 15–340 μg/kg, P = 0.03). The area under the pain intensity–time-curve was lower in the ketorpofen-group (49 ± 26 score hour) than in the placebo-group (68 ± 24 score hour) (mean difference 21 score hour, 95% CI for diff: 3–40 score hour, P = 0.026). There was no difference between the two groups in adverse events, 4/14 in the ketoprofen group and 8/17 in the placebo-group developed oxygen desaturation, and one patient in the ketoprofen-group developed bleeding at 5 h after surgery. Conclusions Intravenous ketoprofen in adjunct to PCA morphine provided a significant opioid sparing effect and improved analgesia in children having chest wall correction surgery.