Sickly chest: causes of deformity

Deformations of the chest

The thorax is the musculoskeletal framework of the upper body, the main purpose of which is to protect the internal organs.

Deformity of the chest is called congenital or acquired changes in the shape of the chest.

They affect the development and full functioning of the organs of the chest (cardiovascular and respiratory systems).

Deformation of the chest is divided into these types:

1. The funnel-shaped deformation is characterized by the fact that the chest is pressed, as it were, into the interior. It is also called "shoemaker's breast
2. The keeled - sternum protrudes forward like the keel of a boat. Another name is "chicken breast".
3. The flat thorax - the sternum-rib complex is flattened in anteroposterior direction. There are also extremely rare types of deformations, such as:
4. Congenital cleft sternum - with this congenital malformation, the patient's breast is split;
5. Musculoskeletal defect - this deformation affects not only the thorax, but also the spine, muscles and other organs (Poland's syndrome);
6. A curved chest is very rare (Currarino-Silverman syndrome).

The degree of severity of the deformation of the chest can be different: from a minimal cosmetic defect to a pronounced pathology.

Behind the location of deformation, it is customary to distinguish the anterior, posterior and deformations of the lateral walls of the thorax.

The way of occurrence of deformation of the thorax is divided into congenital and acquired.

Quite often, parents tend to blame themselves for the appearance of any deformities in the baby.

But, basically the majority, deformation of a thorax is a genetic congenital defect which, fortunately, probably to correct.

If the deformation is congenital, then in such situations the shape of the anterior part of the chest is changed. Such violations are accompanied by underdevelopment of the ribs or their absence, underdevelopment of muscles and sternum.

The causes of acquired deformities include various diseases (rickets, scoliosis, chronic lung diseases, tuberculosis of bones), trauma, burns that occur in the thoracic region cells.

If the formation of bone structures is disturbed, the most severe forms of deformation can occur.

The most common defect of the breastfish is its funnel-shaped form. And in boys it is more common than in girls. The front sections of the ribs, costal cartilage, sternum sink.

In this case, the volume of the thoracic cavity is reduced. With pronounced forms of funnel-like deformation, the spinal curvature, changes in venous and arterial pressure, disruption of the lungs and heart, displacement of the heart are observed.

In traumatology, the funnel-shaped deformities are divided into three degrees:

• I degree. The heart is not biased. The depth of the funnel is a maximum of 2 centimeters.
• II degree. The heart shifts to 3 centimeters. The depth of the funnel is about 2-4 centimeters.
• III degree. Displacement of the heart more than 3 centimeters. Depth of the funnel - from 4 centimeters or more.

The younger the child is, the deformation is less noticeable. According to the so-called paradox of inspiration, it is during this time that the sternum and ribs become worse.

Already closer to the age of three years of the child, pathology begins to gain more pronounced forms.

Children with this problem suffer from frequent vegetative disorders, lag behind in physical development, and have weakened immunity.

Subsequently, chest breathing excursions decrease three to four times, compared with the norm. Begins to develop thoracic kyphosis and scoliosis.

Deformation becomes fixed. Gradually, the depth of the funnel increases.

On the increase there are violations of the development of the respiratory system and cardiovascular.

The main cause of the appearance of the keeled deformity of the chest is an excessive growth of the costal cartilage (mainly cartilage of 5-7 ribs). The breast creases forward and gives the child's breast the shape of the keel. More pronounced pathology becomes with age.

Gradually, the cosmetic defect becomes more and more noticeable. But from this type of pathology, the spine and internal organs practically do not suffer. The heart takes on the form of a drop. The child can complain of rapid fatigue, palpitations, dyspnea.

This pathology is very dangerous because the anterior part of the heart and the major large vessels do not fall under the protection of the sternum, but are directly under the skin.

In this area, it is possible to visually determine the pulsation of the heart.

Acquired deformities of the chest are very diverse. This diversity directly depends on the causes that caused them. For example, the cause of development of emphysema of the chest is chronic emphysema of the lungs.

The sternum becomes in the form of a keg, the ribs are arranged horizontally, and the intercostal spaces are widened, the anterior part of the thorax is enlarged.

The child may have impaired diaphragm mobility, problems with heart function, weakened breathing.

The scaphoid thoracic develops in children suffering from syringomyelia (a disease of the nervous system in which motor functions and sensitivity are impaired). In children with this deformity, a scaphoidal depression appears on the upper and middle parts of the sternum.

• It is possible to diagnose deformity of the chest even by external signs.
• From the instrumental methods of research, X-ray examination is carried out, it allows to evaluate the shape and degree of deformation. Computed tomography of the chest determines bone defects, the degree of deformity, the presence of compression of the lung, the presence of mediastinal displacement. Magnetic resonance imaging is performed to obtain more information about bone and soft tissues.
• Diagnosis of the heart and lungs, due to chest deformation, requires a comprehensive examination: echocardiography, pulmonary radiography, heart monitoring by Holter, etc.

The best way to avoid the acquired form of chest deformation is the timely treatment of lung diseases.

Treatment depends on the degree of deformation, the presence of functional disorders of the heart and respiratory organs.

With small deformations (funnel-shaped or keel-shaped), conservative treatment methods can be dispensed with, such as massage, exercise therapy, wearing corsets, swimming, breathing exercises, physiotherapy.

And if the child has already the second or third degree of deformation, then conservative treatment is beyond his power to correct defects, it can only stop the progression and preserve the functionality of the organs thorax. At these stages, as a rule, doctors recommend surgical treatment.

Its essence lies in creating a vacuum above the funnel, which will pull out the funnel. But in situations where this method is not effective, they can prescribe sternochondroplasty.

Age 6-7 years is considered the most optimal for this operation.

Another method of surgical intervention is a minimally invasive operation using the Nass method. After it, no gross scars remain.

In the sections on the sides, metal plates are installed, the purpose of which is to straighten the sternum and constantly fix it in the correct position.

To the child such plates are established for 3-4 years, after which they are removed. During this time, the thorax is in the correct shape.

In the situation of keeled deformity, surgical treatment depends on the presence of functional disorders and the degree of defect severity. And yet, at an early age, wearing a corset is considered effective, which subsequently often excludes surgical interventions.

Mandatory surgical intervention requires a cleft of the thorax. The type of operation depends on the child's age.

Up to a year after the excision the sternum is sewn along the middle line, since the bones at this age are flexible, they can "connect" with each other.

Surgery is a very effective method of treatment, a positive result is obtained by 90-95% of children, and only one in thirty children may sometimes need a second operation.

A source: https://mamapedia.com.ua/health/baby-health/deformatsii-grudnoi-kletki.html

Sour chest in children and adults, features of treatment of the disease

The sagging chest is one of the rare deformations of the skeleton (prevalence, 1%), pathology is more common in men than in women.

The disease is a curvature of the chest, it is not only an aesthetic problem, but it can also create unpleasant consequences for the functioning of internal organs.

At the appearance of the first signs should immediately begin treatment, the pit on the chest can lead to the development of various diseases, psychological problems.

Causes

The sagging chest is associated with a funnel-like deformation, the fossa in the chest can be congenital / acquired.

Causes of congenital deformity:

• violation of the bookmark / development of bones and cartilage;
• uneven development of bone-cartilage structures;
• other dysplastic phenomena;
• the peculiarities of placement in the womb, especially in case of hypochondria.

The causes of acquired changes in the chest:

• metastases, tumors;
• osteomyelitis;
• osteoporosis;
• tuberculosis;
• trauma;
• purulent-inflammatory diseases of the pleura and mediastinum;
• rickets.

Classification

Distinguish several degrees of the disease, the distribution takes into account the type, magnitude and clinical course of the pathology, the pit on the chest can be of different depth, the severity of the disease depends on this.

Classification of gravity:

• 1 tbsp. - up to 20 mm;
• 2 tbsp. - up to 40 mm;
• 3 tbsp. - from 40 mm.

Classification by morphological features:

• sloping;
• flat-funnel-shaped;
• round / oval;
• hook-shaped;
• symmetrical;
• asymmetrical.

All these characteristics are important for an accurate diagnosis and treatment choice, since in each specific case the cavity on the chest requires an individual approach.

Important

The degree of severity of the pathology depends on the diagnosis, the course of the pathology and the choice of therapy needed to correct the disease.

Symptoms

The clinical picture is accompanied by local signs and abnormalities of the internal organs. In children, the cavity in the chest is noticeable by deepening of small dimensions.

Characteristic features include paradoxical breathing, crying and crying is accompanied not by protrusion, but by the sternum of the sternum.

As the disease develops in the area of ​​the costal arch, convexity begins to appear, under which a furrow appears.

Additional symptoms in children by age:

• up to 3 years - prolonged, recurring diseases of a viral origin, passing into pneumonia;
• 7-10 years - shortness of breath during and after exercise, fatigue, sore throat, increased incidence of viral infections, in 20% of cases, the curvature of the spinal column is manifested, the functioning of internal organs is less often diagnosed (lungs, a heart).

As you grow up, the following symptoms appear:

• weight loss;
• hypotrophy of the muscles of breathing;
• sweating;
• abdominal enlargement;
• decreased appetite;
• omission of the shoulder girdle;
• scoliosis;
• thoracic kyphosis.

In adolescence, a sunken chest in a child is formed definitively, often such children develop poorly physically, have weakened muscles.

The disease also affects the psychological state, often manifested shyness, apathy, alienation, which can have a negative impact on the conduct of a full life.

In adult men, the dumbbell is not limited to visual abnormalities, the disease often develops progressive curvature of the spine, disturb the pain in the heart and back, there are arrhythmias, there is a risk of developing hypertension, osteochondrosis.

Treatment

Treatment in newborns

After the diagnosis is made, the treatment should be started immediately, while the child is small, the most conservative methods are considered effective (special breathing, exercise therapy, massage, swimming, wearing corset). During the formation of the skeleton, special exercises can be very effective. The course of treatment is selected depending on the severity of the pathology and condition of the baby.

Important: Despite the fact that the treatment of pathology requires special skills and education, parents can slow down the development of the disease themselves at home.

Exercises:

1. Put the baby on his back, spread the handles at a 90-degree angle, and squeeze, pressing to the chest, repeat 10 times.
2. The child also lies on his back, pull his legs to his chest, straighten, repeat the manipulation in a couple of seconds, do 10 times.

This gymnastics should be carried out 3 times a day for half an hour before or one hour after a meal.

Read the same: Subchondral osteosclerosis and what it is

The child is also advised to give hold in the hands of not very heavy toys and different objects of large sizes. Such an exercise is similar to the raising of shells in adults, as a result of strengthening the hands, develop the muscles of the chest and shoulder girdle.

Massage, respiratory gymnastics, physical activity

The course of massage is aimed at strengthening the muscles, improving blood circulation and enhancing metabolic processes.

Breathing exercises include a tense breath, which the child should be taught to do by a specialist.

Increase the size of the chest to young children will help swimming, at an older age recommended running, cycling.

Important

If there are signs of fossa on the chest, parents should not panic, systematic efforts to remedy the situation will be rewarded.

With too rapid development of the disease, surgical intervention is recommended.

Treatment in adults

Complex of exercises for adults

In a more mature age, a hollow chest in men also requires certain exercises, the action of which is aimed at widening the sternum and intercostal space.
Exercises:

1. Stand up your legs apart, take a gymnastic stick with two hands from different ends, move your hands behind your back, bring them to the opposite position, repeat 20 times with the strain of the abdominal press.
2. Lie on your stomach, stretch your arms out to your sides, bend over your breath, raise your head gradually, shoulder girdle, hands, connect the scapula together for 8 sec., return to the starting position on exhalation, make 5 time.

In adulthood, attention should also be paid to breathing exercises, physical activity (skis, bicycles, swimming pools).

Operative intervention

Finally, the defect can be eliminated only by surgical methods. To date, there are about fifty different types of operations on the chest. At deformations of 1 and 2 degree palliative techniques are shown, at 3 degrees - extremely radical.

Palliative surgery (Nass method) suggests the introduction of titanium implants under the chest, which in 3-4 years are subject to removal.

The operation is performed only after 13 years, because as the skeleton is formed, the cosmetic effect of the operation can be lost.

Radical methods are conducted with the purpose of increasing the size of the chest, they assume a dissection of the sternum and the cartilaginous part of the ribs.

In the process, a part of the bones is removed, special seams and fixatives are used to fix the front part of the sternum.

On the vacated place a plate with rectifying effect is installed, after which the doctor puts seams

Important

If the surgery is caused by aesthetic problems, then it is recommended to postpone it for a later period. The optimal period for it is considered to be an age not younger than 10 years, this is due to the compliance of bones and the adaptability of the body to the introduction of anesthesia.

Results of surgical intervention

The effect after surgery can be evaluated only after 3-6 months, the evaluation is not only the appearance, but also the restoration of the functioning of the chest organs.

A good result (50-80%) is a complete removal of the cavity on the chest, finding within the limits of the norm water-salt and acid-base metabolism, lack of paradoxical breathing, heart dysfunctions and lungs.

The result is satisfactory (10-25%) while maintaining a small deformation and the presence of small functional disorders (in the absence of complaints).

Unsatisfactory result (also 10-25%) - relapses, the presence of complaints, lack of improvements.

Conclusion

Sternum deformity is a complex disease that can lead to serious complications (diseases of the internal organs, psychological problems. Therapy is prescribed by the doctor in accordance with the individual clinical picture.

It is recommended to begin treatment as early as possible, especially when it comes to young children, in severe cases, a surgical intervention (palliative, radical) is performed.

A source: https://spinous.ru/diseases/vpalaya-grudnaya-kletka-u-detej-i-vzroslyx-osobennosti-lecheniya-zabolevaniya.html

Deformation of the chest: degree, causes, treatment. Funnel and keeled deformation of the chest

Deformation of the chest can be both congenital and acquired. It is accompanied by a significant change in shape. This pathology is considered very serious.

General information

The thorax is a kind of skeleton of muscles and bones. Its main task is to protect the internal organs of the upper body.

It is now established that the deformation of the chest has a negative impact on the heart, lungs and other organs.

This pathology entails irregularities in the normal functioning of various systems.

General information on the Giжиycka Index

This is an x-ray indicator, which is optimal at the present time. This index is used to accurately determine the degree of deformation of the chest. Thanks to him, specialists can decide on the need for surgical correction.

Main classification

All possible variants of this pathology are divided into two main groups.

As mentioned earlier, deformation of the chest can be both congenital (dysplastic) and acquired. The latter are much more common.

Their development is often influenced by the following factors:

1. Bone tuberculosis.
2. Scoliosis.
3. Severe trauma and burns in certain areas of the sternum.
4. Rickets.
5. Chronic lung diseases.

Any deformity of the chest (congenital) implies the presence of serious anomalies or underdevelopment of the following areas:

1. The spade.
2. Breasts.
3. The spine.
4. The muscle of the chest.
5. Ribs.

The most severe deformity of the chest is less common. The causes lie in the presence of a significant disruption in the development of bone structures.

Additional Information

Infringements are subdivided into forms depending on localization of a pathology. Deviations of the following walls occur:

Deformations can be very diverse. In some cases, this is a slightly noticeable cosmetic defect, and in others - an incredibly crude apparent pathology. The latter most often causes significant disturbances in the functioning of the lungs and heart.

Features of congenital changes

In this case, deformations of the anterior region of the chest are always observed. Often the pathology is accompanied by a serious underdevelopment of muscles. In some cases, there may be no ribs at all.

Funnel-shaped deformation of the chest

This pathology is accompanied by a noticeable sinking of individual zones. This, in particular, the front sections of the ribs, cartilage or sternum.

This is a fairly common defect in development.

Funnel-shaped deformation of the chest often occurs due to the presence of serious genetic changes in the structure of cartilage and connective tissue.

Clinical picture at a younger age

This pathology very often causes other ailments. The deformation of the chest in children occurs during their active growth. During this period, changes in the shape of the bones occur. In particular, this refers to the spine.

Changes in the location of internal organs and disturbances in their work are also very often observed. The deformity of the chest in children is accompanied by multiple malformations.

With regard to such cases, in the anamnesis (family history) it is possible to identify several similar pathologies that are available to the closest relatives. This disease is characterized by a pronounced sternal sternum.

There is a significant displacement of the heart, serious problems in the lungs begin. Often there are dangerous changes in venous or blood pressure.

Stages of the disease

Modern specialists in traumatology distinguish them only three:

• The first degree. In this case, the depth of the funnel does not exceed 2 cm. At the same time there is no displacement of the heart.
• The second degree. It is characterized by the following depth of the funnel: 2-4 cm. At the same time there is a displacement of the heart (up to 3 cm).
• Third degree. In this case, the depth of the funnel is from 4 cm or more. At the same time, the displacement of the heart exceeds 3 cm.

Features of the course of the disease at an early age

In most infants, the presence of such a pathology is almost imperceptible. Only during the inspiration there is a significant fall in the ribs and sternum. Pathology becomes more pronounced as the child grows.

In the future, it reaches its maximum. Very often, such children begin to lag far behind in physical development.

Also in most cases, their companions become serious vegetative disorders and colds.

Further flow

With the subsequent development of deformation, the chest becomes fixed. In this case, the depth of the funnel can increase up to 8 cm. The child begins to develop scoliosis. In some cases, appears thoracic kyphosis.

There is a decrease in the respiratory excursion by about three to four times, if we compare with the age norms. There are serious violations in the work of the cardiovascular and respiratory systems.

Many children suffering from this pathology are asthenic. In most cases, the vital capacity of the lungs is reduced by 30%. There are often manifestations of cardiac and respiratory failure. Gas exchange in the blood is very difficult.

Children often complain of rapid fatigue and chest pain.

Conducting diagnostics

This procedure consists of a whole complex of different studies. These include: lung radiography, ECG and echocardiography. Based on the results of the above manipulations, specialists can establish the degree of changes in the activity of the heart and lungs.

Features of therapy

At present, it is proved that the use of modern conservative methods in the presence of this pathology is extremely ineffective.

If the child is diagnosed with severe chest deformity, the reconstruction operation contributes to the creation of normal conditions for the functioning of the internal organs.

This is a very serious surgical intervention. Usually the operation is planned when the child has already reached the age of six.

If a deformity of the chest is detected, the exercises will not contribute to the complete elimination of the patient from pathology. As a rule, the following are recommended:

1. Hyperbaric oxygenation.
2. Physiotherapy.
3. Acupressure of the chest.
4. Swimming.
5. Special therapeutic exercise.
6. Respiratory gymnastics.

All of the above exercises must be performed. This is necessary in order to prevent the possible progression of pathology.

Kiel deformation of the chest

In general, this pathology is caused by the presence of excessive overgrowth of the major costal cartilage. In this case, the sternum of the patient always protrudes.

This is due to the fact that, as a rule, there is a proliferation of cartilages from 5 to 7 ribs. For this reason, the breast takes the form of a keel.

In the presence of such pathology, an increase in its anteroposterior size often occurs. The child grows, and the deformation manifests itself more and more noticeably. There is a visible cosmetic defect.

1. Fast fatiguability.
2. Palpitation (in the presence of physical exertion).
3. Severe shortness of breath.

If the child has a strong keeled deformation of the chest, then surgery intervention is appointed when there are irregularities in the functioning of internal organs. Surgical manipulations are not indicated for those children who have not yet reached the age of five.

Diagnosis and therapeutic measures

The keeled deformity is confirmed even during the initial examination. The diagnosis is made by an orthopedic surgeon. Then the patient undergoes X-ray examination. Thus, the type and extent of the existing pathology is determined.

After this, the specialist selects the appropriate therapy. If the patient has confirmed deformity of the chest, the treatment is not limited only to respiratory and physical exercises. The fact is that often they can not provide the necessary correction.

This pathology is not affected by therapeutic exercise. However, the chest can become more supple thanks to swimming.

With regard to correction using modern orthopedic devices, it is effective only at a fairly early age. In the most severe cases, specialists are forced to resort to surgical interventions.

The keel-shaped deformation is significantly different from the funnel-like shape, which is much more serious. The first does not have a significant effect on the work of all internal organs. The development of the children's spine is also generally stable.

In some cases, there are violations in the functioning of the heart. As for modern surgical correction, it is performed only if there are certain cosmetic indications.

Acquired pathologies

In practice, different cases of violations of the development of the area under consideration are known. One of these is the emphysematous thorax. It is about increasing the airiness of lung tissue.

In the presence of this pathology, the shape of the chest gradually changes. This is due to the fact that the disease is accompanied by an increase in the lungs. There is a change in the anteroposterior size of the thorax. It gradually increases.

The patient's chest becomes a rounded shape.

Features of the paralytic form

This pathology, as a rule, occurs in the presence of diseases of the pleura and lungs (chronic). In this case, the organ decreases. The same happens with the lateral and anteroposterior size of the thorax.

In this case, there is a sinking of the intercostal spaces. Accordingly, it becomes difficult for patients to breathe. Scapula and clavicle are also clearly visible. This is due to the fact that their location relative to the sternum and ribs varies.

Symmetry of movements is disrupted.

The navicular form

Most often, this pathology is observed in patients with a rare disease. It's about syringomyelia. In the presence of this disease, cavities appear in the spinal cord.

For pathology, a change in the composition of bones is characteristic. This is due to the fact that calcium salts are washed out of them. Bones can become deformed, as they become less rigid.

The disease is accompanied by scaphoid indentation of the chest.

The kyphoscoliotic type

This form of deformation is due to spinal disorders. The disease can be a consequence of the following phenomena:

1. Injury.
2. Scoliosis.
3. Rickets.
4. Tuberculosis of the spine.
5. Surgical interventions.

Purpose of optimal therapy

Most of these acquired pathologies are a consequence of chronic diseases. They do not pose a threat to the lives of patients.

If a patient has congenital deformity of the chest, the treatment can also be successful. In this case, conservative methods are ineffective.

Surgical intervention is prescribed when there are abnormalities in the thoracic organs. It can also be shown if there is a pronounced cosmetic defect.

Features of reconstruction

During the procedure, the fallen parts are returned to their places. They are fixed mechanically. In the presence of a keeled deformation, the rib cartilage is truncated. In the case of this pathology, surgical interventions are much less frequent.

Now there are also new methods of treatment. In the area that needs correction, a magnet is implanted. The second is arranged in such a way that their interaction is aimed at correcting the defect.

Some cosmetic problems are masked with silicone implants over the deformation site.

A source: https://www.syl.ru/article/158950/new_deformatsiya-grudnoy-kletki-stepeni-prichinyi-lechenie-vo

Spleen chest in a child: reasons, treatment, photo

The deformation of the ribs, known as a sunken chest, sunken chest, chest of a shoemaker, refers to orthopedic diseases. Among professionals, it is called the funnel-shaped deformation of the chest - VDGK, differing from the keeled deformation of the chest - CDG.

It occurs at a frequency of about 1 to 300-400 children (3-4 times more common in boys), it is rarely dangerous for life.

Causes

Usually, EDC occurs in large children asbirth injury, less often occurs during pregnancy or occurs after childbirth.

It is often associated with chondrodysplasia - accelerated growth of bones in length, disturbances in the structure and metabolism of collagen (protein connective tissues), sometimes with hereditary diseases (neurofibromatosis, Turner syndrome, Morfan syndrome and others).

Signs and Symptoms

Infants up to a year often do not have external manifestations, they are judged on the basis of indirect symptoms: difficulty and confused breathing, regurgitation and vomiting after eating.

Later, when looking at the baby's chestdent, often asymmetrically curved at once "striking usually accompanied by a fragile physique, a bulging belly, pallor, rapid fatigue and shortness of breath.

To determine the severity of the disease, the method and the duration of treatment requires a variety of additional diagnostics.

But, even "cosmetic" deformation interferes with the work of all organs of the thorax under peak loads, making it difficult for a child to participate in active games, and later - not allowing to engage in athletics and power sports, spoiling the posture and figure (stoop, flat chest).

Exercises

To alleviate the condition, since birth, a physiotherapy exercise is needed to develop respiratory muscles, initially under the supervision of a physician, limiting the intensity5-10 exercises in a row.

Later - active games involving the hands, swimming, skiing, aerobics, volleyball, bicycle, exercises with a gymnastic stick.

When and why should I treat

The usual age of treatment is two periods:from 3 to 6 and from 11 to 14 years.

Delay with treatment leads to a decrease in the volume of the lungs, to a displacement of the heart in a spiral and a shift to the left, to increased pressure on vital organs, as well as secondary problems (bronchopulmonary diseases, scoliosis, anemia). In severe cases, fatal problems such as arterial aneurysm or aortic rupture are possible.

Types of treatment, materials and devices

Cosmetic: introduction into the dent of the "macroline" gel or implantation of the polymer mesh plate.

Non-surgical: "Penza technology" using an elastic gasket superimposed on the area of ​​deformation of the chest and lid, under which vacuum is created for a while (similar versions of the vacuum bell and vacuum lift are known in the US and the EU). It is more effective in younger (and younger) age group, and also at repeated application.

Combination of surgery with subsequent thoracoplasty:

• Thoracoplasty by Gross- the thread or line is planted directly under the bone of the sternum and, putting on a bulging outer corset, pulls up to it the sternum; duration of treatment - up to 12 weeks.
• Thoracoplasty for Marchev- After the bone is cut, the bone of the sternum or sternum together with the bones in several masses are attached to a convex outer corset with a strained lavsen thread.
• Thoracoplasty by Plaexeychuk- use of an extensive T-shaped incision of the sternum and the corresponding T-shaped external fixation device (corset), connected with the ribs by a set of pull-up spokes; extract 10-15 days, the device is removed after 1 month.
• Dnepropetrovsk technology- on the ribs fix the titanium plates or frames, attaching to them the strings gradually tightened with the help of screws outer corset; the duration of treatment is up to 6 months, the outcomes are generally safe, but require the strictest asepsis and antiseptics.
• Magnetosurgical correction, on the ribs under the skin fixed stationary magnets, and on the outer corset - paired magnets.

Surgical intervention, about 50 ways.

Produced as without the use of implants (among them the methods of Ravich, Vinogradov, Kondrashin, Urmonas), and with implants (among Nasses technology with the implantation of a C-shaped bent steel plate under the bone of the sternum, thoracoplasty of metal tires and fixers for Rehbein, a metal plate and nylon sutures in Palta and Sulamaa, metal-titanium-chondroplasty of a titanium plate according to Timoshchenko).

Prospects

Approaches to the treatment of a hollow thorax in a child, especially in terms of surgical methods and materials, are now largely obsolete.

Treatment in Russia and in the West is often determined not so much by objective indications and technical opportunities, how many practice in each region and hospital, market conditions, cosmetic demand.

Proceeding from the principle "the salvation of drowning is the work of the drowning themselves parents should be more active, not hoping for "medicine" as such, and turning to doctors for help, ready to meet in real treatment.

It seems that the "initiative" of interested doctors and enthusiastic parents is especially necessary in terms of improving the material and technical operational base.

Probably, modern 3D printers and biocompatible, biodegradable materials, such as PLA (polylactic acid) can make a real breakthrough in this business.

A source: http://ru-babyhealth.ru/vpalaya-grudnaya-kletka-u-rebenka-prichiny-lechenie-foto/

How do they fix a hollow chest in men?

Sinking chestIs a congenital pathology, registered in% of all people on the planet. In medicine, this condition is called funnel-shaped deformation of the chest (DVGK).

In a mild form it does not pose a danger to the health of a man and is only an aesthetic defect. Deformed strain can lead to disruption of the function of internal organs and the formation of serious complications.

Causes

In most cases, the funnel-shaped deformation of the chest is a congenital disease. The exact causes of the defect are not known.

The effect of ionizing radiation, drugs and other factors affecting the fetus is assumed.

A breakdown in genetic material and the possibility of inheriting the disease are not ruled out.

Rickets is one of the reasons for the development of HDCP

The sagging chest also has another name - "cobbler's chest". A similar deformation was noted earlier in adolescents - students of a shoemaker.

While working, the boy was forced to keep his shoes so that her heel rested against the lower part of the sternum, which inevitably led to the deformation of fragile bones.

In the modern world, such a condition is almost not found, and now the sunken chest is recorded primarily as a congenital malformation.

Factors that can lead to deformation of the chest after birth:

• rickets;
• osteomyelitis - purulent inflammation of bone tissue;
• tuberculosis of bones;
• tumors;
• injury.

DVMC is the most common defect in the development of the chest (up to 96%). In men, the disease is more common than in women (up to 70% of all cases are in newborn boys).

Symptoms

To suspect congenital defect of a thorax it is possible already in a maternity hall at survey of the newborn. At the junction of the sternum with the ribs, there is a slight dehiscence of the bones. Over time, this deepening increases.

DVGK - congenital malformation, progressing as it grows

Its deformation reaches its peak by 3-5 years, when other accompanying changes in the skeleton become noticeable:

• kyphosis - curvature of the spine in the thoracic region with back bend and possible hump formation;
• kyphoscoliosis - the curvature of the spine from right to left is added;
• shoulder drop;
• protrusion of the abdomen forward;
• hypotrophy (underdevelopment) of the respiratory muscles.

After 5-6 years, the progression of the disease slows down, however, already existing changes do not disappear. Finally, deformation is formed towards adolescence.

There are three degrees of severity of the disease:

• 1 degree - chest augmentation up to 2 cm;
• 2 degree - 2-4 cm;
• 3 degree - more than 4 cm.

3 degrees of severity of the disease

In clinical practice, various types of HDR are also determined, which makes it possible not only to diagnose, but also to determine the further tactics of treatment.

Complications

A sagging chest is not only an aesthetic defect. The depression of the bones leads to an inevitable displacement of the internal organs, which adversely affects their work. The heart and lungs suffer most, which leads to the appearance of such conditions:

• displacement of the axis of the heart to the left;
• compression of the heart and lungs;
• a decrease in the vital capacity of the lungs.

Displacement of the heart leads to an overload of its right divisions, which in the future can cause heart failure.

Quite often the acquired heart valve defects are recorded (usually mitral valve prolapse, but variants are possible).

All the changes that occur in the most important organ of the human body can be traced to the ECG or echocardiography.

Displacement of the heart can lead to heart failure

Displacement of the lungs leads to a decrease in their vital capacity. There are problems with breathing, quite often there is shortness of breath.

In childhood and adolescence, there is a delay in physical development, a tendency to frequent colds.

Such a state prevents the adolescent from adapting adequately to society and creates difficulties in adult life.

In young men, along with the symptoms already described, other unpleasant conditions also arise:

• increased blood pressure;
• arrhythmia;
• dyspnea;
• pain in the thoracic and lumbar spine;
• pain in the heart.

All these symptoms are associated with compression of the internal organs and indicate a violation of their normal functioning. In severe cases, a sunken chest becomes not just a cosmetic defect, but creates a serious threat to the health and even the life of a man.

Diagnostics

Chest x-ray at CDPD

The detection of pathology is not particularly difficult, since the hollow thorax is seen well in the initial examination. To clarify the severity and identify the concomitant pathology, such examinations are conducted:

• Chest X-ray;
• computed tomography with 3D rib design;
• MRI.

All these studies allow not only to assess the shape of the chest, but also to identify the features of the articulation of the ribs, the state of cartilage, the degree of deformation and displacement of internal organs. To assess the condition of the heart, an ECG, echocardiography and other tests are required.

Principles of therapy

In the treatment of a hollow chest, two methods are distinguished:

Conservative therapy

The funnel-shaped deformation of the chest can not be corrected 100% by conservative methods.

All that the doctor can do is to improve the patient's condition, remove, as far as possible, a visible aesthetic defect and facilitate the functioning of the organs.

The less the degree of deformation, the greater the chances of a favorable outcome and the opportunity to live a full life without significant restrictions.

Methods of conservative treatment:

• massage;
• physiotherapy;
• Respiratory gymnastics for improving lung function;
• swimming;
• wearing orthoses.

Orthoses are special devices by which the thorax is fixed from the outside. You need to wear orthoses for a long time for many years.

The effect of such therapy should be expected only in childhood and adolescence, until the bones are formed.

In adult men this method of treatment is not applied.

The wearing of orthoses is only shown in childhood and adolescence

The vacuum lift is another good technique for conservative therapy. It is used in a situation where the chest is sufficiently mobile.

In Russia, this technique is not very popular, but is in demand in clinics in Europe.

With minor deformations without a significant disruption of the function of the heart and lungs, Macrolane gel is used to correct it. The drug is injected into the indentation, which allows you to correct a cosmetic defect. The procedure is quite safe and can be performed on an outpatient basis.

Surgery

Indication for the operation:

1. Violation of the function of internal organs (heart, lungs) against the background of deformation of the chest.
2. Pathology of the spine, associated with DVGK.
3. Cosmetic indications.

The operation is performed in the case when conservative therapy did not bring the desired effect or was immediately abandoned because of severe deformity of the thorax.

Spleted chest is surgically corrected if therapy is not effective

There are several types of surgical treatment:

1. Application of silicone implants. Shown with slight deformation. It allows to achieve only improvement of appearance, does not affect the functioning of internal organs.
2. Correction by the method of Nass.
3. Operation using the Ravich method.

The Nass method is one of the most popular methods of surgical treatment. The surgeon makes two incisions along the sides of the chest.

In the sections, a videotorakoscope is introduced - an endoscopic device, through which the operation is performed and all the actions of the doctor are monitored. At the first stage, the surgeon applies titanium plates.

The second stage is carried out after 4 years, and then the plates are removed, and the chest is straightened. Thus the patient quickly enough comes back to a habitual life.

Restrictions on physical activity last no more than 1 month after each stage of the operation. During the wearing of plates, the patient is allowed to gradually increase the load and after 6 months even sports are allowed.

Ravich's method is similar to Nass's operation in fact, but here all the manipulations are done through a large incision on the chest. After such an operation, recovery takes much longer. In recent years, minimally invasive techniques have been given priority.

Operative treatment for a hollow thorax is recommended for adolescence.

At this time, the bones are still pliable enough, but at the same time the risks of the effects of anesthesia and the operation itself are less than that of small children.

At children surgical correction is spent only on vital indications.

An adult can also be offered surgery if necessary.

Recommended for viewing:

A source: http://MenQuestions.ru/articles/vpalaya-grudnaya-kletka-u-muzhchin.html