RESUMO
AIM: To improve the results of surgical treatment of pectus carinatum. MATERIAL AND METHODS: The work included 47 pectus carinatum patients aged 3-15 years for the period from 2000 to 2015. All patients were divided into 2 groups depending on surgical approach: control group - 23 (48.94%) children who underwent thoracoplasty by M.M. Ravitsh procedure with the use of device for pectus carinatum repair of our design; main group - 24 (51.06%) patients where our method of thoracoplasty based on changes of deformed ribs biomechanics was used. RESULTS: In control group good results were obtained in 15 (65.3%) patients, satisfactory - in 5 (21.7%) patients, recurrent deformation with all consequences was observed in 3 (13%) cases. Long-term results of surgical treatment by original method were followed-up in all 24 patients and good outcomes were obtained in 100% of children. CONCLUSION: 1) Intraoperative 'spring' - effect is a provoking risk factor of recurrent chest deformation. 2) The new surgical method based on breaking the ribs bodies in 'green branch' fashion provides good results and does not require external devices to hold sternal-rib complex in corrected position.
Assuntos
Pectus Carinatum/cirurgia , Costelas , Esterno/cirurgia , Toracoplastia , Adolescente , Fenômenos Biomecânicos , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pectus Carinatum/diagnóstico , Pectus Carinatum/fisiopatologia , Prognóstico , Recidiva , Reoperação , Costelas/patologia , Costelas/fisiopatologia , Costelas/cirurgia , Fatores de Risco , Esterno/anormalidades , Esterno/fisiopatologia , Toracoplastia/efeitos adversos , Toracoplastia/métodos , Resultado do TratamentoRESUMO
Congenital spastic torticollis was surgically treated in 98 children. An original orthopedic device was used in 31 children. A comparative analysis of the results depending on the kind of immobilization and means of correction in 79 children showed the device to provide good results and to shorten the time of the treatment.