Surgery for convex, concave sternum malformations

The article was consulted professionally by Specialist 2 Mai Anh Kha – Orthopedic Surgeon – General Surgeon – Share99 Da Nang International Health Hub

Convex sternum malformations, concave sternum malformations or sternum concave are a congenital pathology that appears at a young age with the manifestation of the chest in the middle being completely convex or deeply concave. Without timely treatment, congenital sternum malformations not only cause cosmetic deformities, but also have many health and developmental implications.

Convex sternum malformations, also known as chicken breast, thoracic convexity, sometimes called pigeon breasts or congenital convex disease, are deformities of the thoracic bone. Characteristic of convex sternum malformation are the sternum and pre-protruding ribs.

Convex sternum malformations in contrast to congenital chest concave malformations. The specific shape of the skeleton deforms to varying degrees in each specific case, the ribs protrude forward, protruding completely or slightly convex.

Thoracic malformations are generally common with a rate of 1 in 400 babies born, of which chicken breast breasts account for about 20% of thoracic malformations.

Congenital concave sternum malformations are abnormal deformities of the thoracic cage due to the abnormal growth of some ribs and sternum that cause the chest to be concave. Concave sternum malformations can be detected immediately after birth or into puberty, most of which are detected immediately after birth.

The natural course of concave sternum malformations is never able to cure itself, which can remain the same level as immediately after birth but, however, the majority gradually worsen from birth to puberty and especially develop rapidly to puberty.

The simplest classification of concave sternum malformations is divided into 2 types: concave and eccentric.

According to Nuss, the classification of concave sternum malformations is based on the shape of the concave area, the length of the concave sternum segment and the twisting of the sternum.

According to author Hyung Joo Park classification:

• Type IA: concave concave concave concave concave locality.
• IB type: flat concave concave concave.
• Type IIA1: concave eccentric concave resident.
• Type IIA2: flat eccentric chest concave.
• Type IIA3: eccentric chest concave creates long channels.
• Type IIB: mixed chest concave, both convex and concave.

Surgery for sternum malformations is the only treatment for concave sternum malformations and convex sternum malformations. There are many methods that are applied such as removing the front chest wall, external pull frame, cutting of deformed rib cartilage across the sternum or using tools with sternum lifting function. However, these methods have the common characteristics of complexity, prolonged operation time, high blood loss, high rate of complications and recurrence.

Currently, surgical treatment of sternum deformities has the same methods and basically 3 types of surgery:

• Balanced concave sternum deformity only needs to bend the balance bar.
• Deviation of the sternum: bending requires more difficulty, making adjustments so that the two sides balance, raise evenly. If the lift does not weigh, it will cause bad breasts. For children with early treatment deviations, it is better because soft bones when lifting will be easy. In addition, the problem of curvature of scoliosis is minimal.

Concave sternum malformation when surgery is in place: You need surgery to treat congenital chest concaveness when the thoracic index is above 3.25 (i.e. Haller's index evaluates the front – back of the chest). This is based on CT scans of layers for accurate evaluation.

Most doctors prescribe surgery for sternum deformity between the ages of 6 and under 18, under 18 years of age with the highest efficiency due to puberty when the chest wall is still developing for easy lifting.

In addition, laparoscopic sternum deformity surgery is also quite common with the addition of breast augmentation bars for lifting, ease of operation, high aesthetics, faster recovery and not to withstand large cuts and not bone cuts. After surgery of sternum deformity about 4-5 days you can be discharged from the hospital, 1 week long. Breast augmentation bars in this case usually leave for 2-3 years, depending on the age:

• For children under 5 years old, breast augmentation bars are usually about 2.5 – 3 years.
• Older children, rapidly reinforced bones usually leave the chest lift bar for 2 years.

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SEE MORE:

• Congenital chest concave surgery
• Congenital chest concaveness in a child: Diagnosis and treatment
• Congenital chest concaveness in a child: Symptoms and complications