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The Annals of Thoracic Surgery, Vol 38, 368-373, Copyright © 1984 by The Society of Thoracic Surgeons
JA Hawkins, JL Ehrenhaft and DB Doty
Pectus excavatum was repaired by the sternal eversion (turnover) technique
in 26 patients over a 7-year period. Vascular supply to the sternal graft
was maintained by preservation of one internal mammary vascular pedicle.
Good results were obtained in 21 (81%) patients followed for periods
ranging from 2 to 76 months (mean, 32 months) postoperatively. Four
patients (15%) had fair results; 2 patients with Marfan's syndrome had
partial recurrence, as did 1 patient with skin necrosis and 1 with
hypertrophic scar. One patient (4%) had a poor early result due to wound
infection and distal sternal necrosis requiring reoperation. Other
complications were minor: superficial wound seroma in 2 patients and
pneumothorax in 1. The sternal eversion technique for repair of pectus
excavatum utilizes the concave shape of the sternum when turned over to
create a cosmetically acceptable convex anterior chest wall contour.
Judicious tailoring of the costal cartilages and shaping of the anterior
sternum corrects asymmetrical deformities. The chest wall is very stable
after repair. Since no prosthetic struts or pins are used, a second
operation for removal is avoided. Preservation of the vascular supply to
the sternum should allow normal growth of the anterior chest wall. The
results have been sufficiently encouraging for us to recommend sternal
eversion as the primary method for repair of pectus excavatum.
ARTICLES
Repair of pectus excavatum by sternal eversion
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