This is 29 year old Irani man who has a congenital inward deformity of anterior chest wall. He was admitted in May 1997 where correction of the deformity was performed. Pic 1 &2
Preoperative chest xray showed the deformity from P-A view(pic.3) and lateral view (pic.4)
What was done?
Excision of the deformed costal cartilages from 2-9 on left sides and from 3-9 on the right side. The xyphoid process was excised as well.
Adhesions were released of sternum and osteotomy of outer table of was performed at the level of 3rd costal cartilage to correct the clockwise twist of the sternum.
A rush pin was passed behind the sternum (pic 5)and fixed to the ribs on both sides by chromic catgut. Lateral view of the pin (pic 6)
The lower end of the sternum was connected to the rectus sheath with merselin mesh
Postoperatively patient was kept in ICU on full ventilation for one day on BIPAP for 2 days and on pressure support for 5 days and on CPAP for another 2 days.
He was then transferred to surgical ward, kept under observation and treated with mobilization and breathing exercises. Patient was discharged on 13/6/97. After 1 1/2 year, A prolin mesh was inserted subcutaneously in the region of epigastrium to keep its normal bulky appearance.
During March 2001, he sustained a blunt trauma to the chest while at swimming pool, and the rush pin was broken (pic.7) and it has been removed later.
Xray chest after deformity was corrected and pin is removed. (pic 8)
Patient was advised to continue excercises to build up his pectoral and epigastric muscles.