Mumtaz H Khan, Naila Yaqub, Hafeez Ur Rehman, Rameez I Hashmi, Hafeez ur Rehman.
Pectus Excavatum Surgery with temporary retrosternal support prevents recurrence of deformity.
J Coll Physicians Surg Pak Jan ;12(10):642-4.

A four-year old male child was admitted with history of exercise intolerance and anterior chest wall deformity for six months. The clinical diagnosis of severe symmetrical pectus excavatum was made (Figure - 1). X-ray chest showed no other abnormality. Cardiopumonary function was assessed clinically. Surgical treatment was planned mainly for cosmetic and functional reasons as the child was unable to perform routine activities. Subperichondrial resection of four posteriorly curved costal cartilages on each side of the chest was performed. Xiphi-sternum was incised and sternal osteotomy was done at manubrio-sternal angle. Retrosternal mobilization was done avoiding rupture of pleura. Stabilization of, thus elevated, anterior chest wall was done with retrosternal Kischner`s wire with bending its both ends over the ribs anteriorly after piercing through relevant costal ends. Postoperative recovery was uneventful and the child was discharged home on 4th postoperative day (Figure 2). Regular follow up was carried out in outpatients department and the Kischner`s wire was removed after seven months. Surgical treatment led to good functional and cosmetic results. There is improvement in exercise tolerance during the routine physical activities involving running etc., suggesting improvement in cardio respiratory function.

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