Modification of surgical treatment by Nuss for funnel chest in children

Purpose. To improve the results of funnel chest surgical treatment in children by developing little invasive thoracoplasty. Materials and Methods. 122 patients (3-17 years) with funnel chest examined and treated. Surgical treatment performed in all cases. Little invasive thoracoplasty by D. Nuss performed in 29 patients. Surgery by the authors’ original technique performed in 93 cases. A new technique of funnel chest surgery described, as well as a correcting plate for the sternocostal complex osteosynthesis. Periods of observation after thoracoplasty were 4 years. Results. The results of modified thoracoplasty in the first year after the surgery traced in 93 patients. No migrations of metal frameworks, damages of mediastinum organs, large vessels, massive hemorrhages, and no lethal outcomes observed. The mean duration of postoperative hospitalization was 8 days. Marked pain syndrome persisted 5-7 days. Verticalization periods in patients were individual and depended on somatic status, pain syndrome severity. Good results observed in 39 cases, satisfactory – in 6, and unsatisfactory – in 2 cases among 47 patients underwent plate removal. Deformity recurrence noted in 2 patients operated at the age of 4 and 5 years, respectively. Conclusion. Effectiveness of proposed technique achieves due to creating strong pressure on the correcting plate in stiffening rib zone because of sternum intention to return to the initial position. Secure jamming of the correcting plate in sternocostal complex zone takes place. As a result of surgery, more secure stabilization of the sternocostal complex creates due to more rigid correcting plate using.