Growth disturbance of the sternum and pectus deformities: imaging studies and clinical correlation.

BACKGROUND: Radiologic reports of "normal" chest are not uncommon when there clearly are irregularities of sternal ossification and maturation. Analysis of imaging studies of sternal deformities for growth disturbances is not common in the literature and is addressed in this manuscript. OBJECTIVE: To determine the influence of sternal growth on development of pectus deformities and correlate imaging studies with clinical aspects of different types of these deformities. MATERIAL AND METHODS: One hundred forty-one children and adolescents with pectus deformities were evaluated. Sternal growth was estimated through the development of radiographic indices that were available for 57 patients with pectus deformities and for 71 controls. Magnetic resonance imaging of the sternum was performed in two patients to correlate with radiographic information. RESULTS: Radiographic indices of the sternum suggested growth disturbances in three basic types of pectus carinatum deformities: superior, inferior and lateral, and in the localized type of pectus excavatum. CONCLUSION: Sternal growth seems to have an important influence on the development of carinatum superior; partial influence on carinatum inferior, carinatum lateral, and excavatum localized; and no influence on excavatum wide pectus deformities. The endochondral growth of the sternum and costal arches is an important concept that aids in the interpretation of imaging studies and the orthopedic approach to management of these deformities in children and adolescents.

Deformidades "pectus": novos conceitos e abordagem ortopédica na infância e adolescência: 1ª parte / Pectus deformities: new concepts and orthopedic approach in children and adolescents: 1st part

As deformidades da parede torácica anterior ou deformidades pectus em crianças e adolescentes têm sido tratadas por especialistas que nao estao acostumados a lidar com a fisiologia do crescimento ósseo e cartilagens, e que leva a equívocos e resultados questionáveis. Estudos sobre a etiologia, patogeina e os resultados obtidos com um tratamento ortótico sao descritos pelo autor, emnfatizando que as deformidades pectus dizem respeito à ortopedia.

Iatrogenic pectus carinatum. A case report.

A boy underwent cardiac surgery when he was 27 months old; prior to that his anterior chest wall had been normal. He later developed a progressive pectus carinatum deformity. Thoracic surgeons are cautioned to be mindful of the sternal and costal growth plates in any surgical approach to intrathoracic structures. Special care is needed when such deformities are corrected in children and adolescents.