Early and Long-Term Results of Surgical Repair of Pectus Excavatum

Abstract

From 1990 to 1998, 30 patients underwent surgery for correction of pectus excavatum. There were 19 (63%) males and 11 (37%) females, aged 4 to 32 years (mean, 12.57 years). Bilateral excision of 4 to 6 costal cartilages and sternal wedge osteotomy were performed on 27 (90%) patients, and Kirschner wires were used for substernal support in 25 (83%). A median sternotomy was carried out in males and a submammary transverse incision was preferred in females. All patients were followed up at yearly intervals. Early results were excellent in all except 2 cases: a 14-year-old boy developed contralateral sternal depression after costochondral excision without sternal elevation for correction of one-sided costochondral hyperplasia; and an 8-year-old girl in whom no Kirschner wires had been inserted developed recurrent minimal sternal depression. Long-term follow-up showed recurrent sternal depression 6 years postoperatively in a boy who had undergone surgery at 4 years old, with early removal of the Kirschner wires. It is recommended that correction of pectus excavatum should be carried out in prepubertal children, and Kirschner wires should be used for substernal support.

Symmetrical excessive pectus excavatum in children

“…Kirchner wires have been recommended for substernal support for 18 days (range, 8–28 days) because they accelerate primary osseous healing and serve to stabilize the condition. 22 While the mean time for Kirchner wire support was 12–14 days in initial cases, it was sufficient to place it for only 5 days in most of the children. During clinical examinations, the Kirchner wire can be removed by applying medium strength when it is mobile and the thoracic cage is fixed.…”

Minimalized Erlangen Correction Method by Hümmer (MEK) Compared with Conventional and Minimally Invasive Correction Methods for Pectus Excavatum Single Center Experience

“…In addition, at an older age, the patients can decide for themselves whether or not to undergo surgery. The use of surgery too early carries the risk of developing new or recurrent deformities [3,13,29]. The mean age of our patient population at the time of surgery was 21.5 years (range: 4 years-60 years).…”