Adolescent ; Adult ; Bone Plates ; Bone Screws ; Child ; Female ; Follow-Up Studies ; Funnel Chest/surgery* ; Humans ; Male ; Orthopedic Procedures/instrumentation ; Orthopedic Procedures/methods* ; Sternum/surgery ; Treatment Outcome ; Young Adult
Keywords
Chest wall ; Minimally invasive surgery ; Pectus bar stabilization ; Pectus excavatum
Abstract
PURPOSE: Pectus bar rotation is a major challenge in pectus repair. However, to date, no satisfactory technique to completely eliminate bar displacement has been introduced. Here, we propose a bar fixation technique using a bridge that makes the bar unmovable. The purpose of this study was to determine the efficacy of this bridge technique.
METHODS: A total of 80 patients underwent pectus bar repair of pectus excavatum with the bridge technique from July 2013 to July 2014. The technique involved connecting 2 parallel bars using plate-screws at the ends of the bars. To determine bar position change, the angles between the sternum and pectus bars were measured on postoperative day 5 (POD5) and 4 months (POM4) and compared.
RESULTS: The mean patient age was 17.5 years (range, 6-38 years). The mean difference between POD5 and POM4 were 0.23° (P=.602) and 0.35° (P=.338) for the upper and lower bars, respectively. Bar position was virtually unchanged during the follow-up, and there was no bar dislocation or reoperation.
CONCLUSIONS: A "bridge technique" designed to connect 2 parallel bars using plates and screws was demonstrated as a method to avoid pectus bar displacement. This approach was easy to implement without using sutures or invasive devices.