Congenital Deformity of the Rib Cage
Congenital deformities of the rib cage occur in every 300-400 live births. Among known morphological deformities, pectus excavatum (shoemaker’s chest) and pectus carinatum (pigeon chest) are the most common. Pectus excavatum (shoemaker’s chest) is characterized with inward depression of the sternum (breast bone), while pectus carinatum causes it to protrude outward. It is usually noticed within the first 1 year and severity of morphological deformity increases as the patient ages. Children suffering from deformities of the chest wall may be severely and psychologically affected by this condition. Due to aesthetical concerns, they tend to be reserved and shy, experience difficulty in communicating with their friends, and lack self-confidence.
Patients with morphological thoracic wall deformities usually require surgical intervention to address psychological concerns rather than physiological issues. Deformities that used to be corrected by removing part of the ribs connected to the sternum are nowadays fixed through closed operations. The “Nuss” procedure, for instance, involves making small incisions and placing a steel rod under the sternum to correct its depression. The rod needs to remain in place for 2-3 years in order for the rib cage to preserve its shape. Success ratio of this procedure is as high as 98%. During the postoperative period, patients enjoy a noticeable improvement in their psychological state, thanks to the boost of self-confidence they receive.
There are various surgical methods aimed at correcting pectus carinatum as well. In terms of the impact it creates, it is also a morphological deformity that leads to psychological issues just like pectus excavatum.
The age group of 12-15 is considered to be eligible for surgical correction of thoracic wall deformities. If placed at an earlier age, removing the rod might cause recurrence of morphological deformity, as bone growth will still be in progress.