Surgical treatment of funnel chest in children and adolescents by metal sternoсhondroplasty

Purpose. To analyze different approaches to optimization of funnel chest surgical treatment using internal fixators in children, adolescents and young subjects. Materials and Methods. The experience of using internal fixators for correction of funnel chest presented in 68 patients at the age of 3-28 years. A frame-like fixator proposed, allowing to perform simultaneous fixation of up to 5-6 adjacent osteotomized ribs and sternum in patients with severe forms of the deformity and a large area of retraction. Patients had Degrees II, III, IV according to Giżycko index. Chondrotomies, radical cartilage resections, costotomies and sternotomy performed during thoracoplasty procedure depending on patient’s age, severity of the deformity. Results. The use of thoracoplasty techniques selected and an individual approach to postoperative management allowed to achieve good immediate and long-term results in 80.8 % of patients. Satisfactory results obtained in 7 (14.8 %) patients, the results were unsatisfactory in 2 (4.2 %) cases. Conclusion. In patients below 10 years with Degree II-III deformity KNIIO fixators are acceptable, in those above 10 years T-shaped fixators are effective, and in cases of Degree III-IV rigid deformities with a large retraction area frame-like titanium plates allowing to fix the whole costosternal complex appear to be more effective.