Costochondral changes in the chest wall after the Nuss procedure: ultrasonographic findings

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• 作者：Qi Zeng ; Jin-Yao Lai ; Xiao-Man Wang ; Jhon-Liau Lee ; Shu-Ti Chia ; Chao-Jan Wang ; Jeng-Chang Chen ; Pei-Yeh Chang
• 关键词：Cartilage ; Pectus excavatum ; Rib fracture ; Thoracoplasty ; Ultrasonography
• 刊名：Journal of Pediatric Surgery
• 出版年：2008
• 出版时间：December 2008
• 年：2008
• 卷：43
• 期：12
• 页码：2147-2150
• 全文大小：396 K

文摘

Purpose

The Nuss procedure is one of the most popular surgeries for correcting pectus excavatum. However, little is known regarding stress and strain on the deformed ribs after inserting the pectus bar. We used ultrasonography to investigate costochondral changes before and after the Nuss procedure.

Methods

Ninety-five patients underwent the Nuss procedure between July 2007 and February 2008 at 2 institutions. Chest ultrasonography, specifically of the bones and cartilage, was performed 1 day before and 1 week after the operation.

Results

Postoperatively, all patients showed various degrees of deformation from the second to sixth cartilages bilaterally. The cartilages were not fractured. Of these patients, 28 (29.5 % ) had significant changes, including acute angulation of the costochondral junction and rib fractures near the pectus bar. These changes were associated with increased age (P < .01) and the degree of postoperative sternum elevation (P < .01). The pectus index and sex were not significant predictors of rib damage.

Conclusions

The Nuss procedure created significant stress and strain over the deformed cartilages. Approximately 29 % of the patients showed localized, self-limited costochondral changes via chest ultrasonography.