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Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling

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Chest pain and chest wall deformity.

Janaki Gokhale¹, Steven M Selbst

¹Jefferson Medical College, Philadelphia, PA 19107, USA.

Pediatric Clinics of North America

|January 13, 2009

Summary

Most childhood chest pain is not serious, but careful evaluation is needed. Reassurance and follow-up are often sufficient for well children without concerning symptoms, but more research is required.

Area of Science:

Pediatric Medicine
Cardiology
Thoracic Surgery

Background:

Chest pain and chest wall deformities are frequent concerns in pediatric patients.
While often benign, serious underlying causes of chest pain necessitate careful clinical assessment.
Limited prospective research exists for evaluating pediatric chest pain.

Purpose of the Study:

To review the evaluation and management of chest pain in children.
To highlight the challenges in establishing clear diagnostic guidelines due to the rarity of serious etiologies.
To emphasize the importance of clinical judgment in differentiating benign from serious cases.

Main Methods:

Review of existing literature on pediatric chest pain.
Clinical assessment of children presenting with chest pain and chest wall deformities.

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Discussion of diagnostic approaches and management strategies.

Main Results:

The majority of pediatric chest pain cases have benign diagnoses.
Serious causes of chest pain in children are uncommon, complicating guideline development.
Children who appear well, have normal examinations, and lack a concerning history may not require extensive diagnostic workups.

Conclusions:

Careful evaluation and follow-up are crucial for children with chest pain.
Reassurance and conservative management are appropriate for low-risk pediatric patients.
Multicenter studies are essential to better define the evaluation and management of pediatric chest pain.