Surgical correction for chest wall deformities were done 44 patients (41 male and 3 fernale patients) since 1989, in ourclinic. The mean age was 21.8 years (range, 15 to 38 years). The indications for operations were cardiac, respiratory, cosmetic and psyhologic. The types of deformities were pectus excavatum in 36 patients (81.8%), pectus carinatum in 5 (11.3%), and mixed deformity in 3 (6.8%). Seven patients (15.9%) had a family history of malformation. The symptoms were dyspnea and tiredness for efforts in 23 patients (52.2%) and palpitations in 12 (27.2%). Five patients had minimal scoliosis. As surgical techniques used in all cases consisted of subperichondrial resection of abnormal costal cartilages, transverse and longitudinal osteotomies of sternum and internal stabilization with a Kirschner wire which was generally removed 2 to 3 weeks. The late follow-up was completed in all patients. The results were graded into one of four groups, according to Humprey-Jaretzki classification; which were excellent, good, moderate, and worse.
There was neither early nor late mortality. Morbidity rate was 6.8%. Twelve patients had pneumothorax either intraoperatively or postoperatively in 6 hours. Cardiac and respiratory symptoms of patients were improved at early follow up. Results were excellent in 30 patients (68.2%), good in 13 (29.5%) and moderate in 1 (2.2%).
Surgical treatment of chest wall deformities in adult patients leads to good cosmetic, orthopedic and psychological results. We believe that the operations should be performed at any age in patients who have at least moderate deformity.