[Surgical treatment of pectus carinatum in children]

Area of Science:

• Pediatric surgery
• Thoracic surgery
• Biomechanical engineering

Background:

• Pectus carinatum is a chest wall deformity requiring surgical correction.
• Existing surgical methods, like Ravitch thoracoplasty, may have limitations, including recurrence.
• External devices are sometimes used to maintain sternal-rib alignment post-surgery.

Purpose of the Study:

• To enhance surgical treatment outcomes for pectus carinatum.
• To evaluate a new thoracoplasty method focusing on rib biomechanics.
• To compare the efficacy of the new method against a conventional approach.

Main Methods:

• A comparative study involving 47 pediatric patients (3-15 years) with pectus carinatum.
• Control group (n=23): Ravitch thoracoplasty with a custom device.
• Main group (n=24): Novel thoracoplasty involving 'greenstick' rib fractures to alter biomechanics.

Main Results:

• The control group achieved good results in 65.3% and satisfactory in 21.7%, with 13% experiencing recurrence.
• The novel thoracoplasty method resulted in 100% good outcomes in all 24 patients.
• No external devices were required for sternal-rib complex stabilization in the main group.

Conclusions:

• The intraoperative 'spring effect' is a risk factor for recurrent chest deformation.
• The new surgical technique, utilizing biomechanical principles of rib fracture, offers superior results for pectus carinatum.
• This innovative method eliminates the need for external fixation devices, simplifying post-operative care.