• A A Fokin and F Robicsek.
• The Department of Thoracic and Cardiovascular Surgery, Heineman Medical Research Laboratories, Carolinas Medical Center, Charlotte, NC 28203, USA. Alexander.Fokin@carolinashealthcare.org
• Thorac Cardiovasc Surg. 2006 Feb 1; 54 (1): 57-61.

BackgroundAcquired chest wall deformities are difficult to describe and to classify. We propose the following classification and treatment options.MethodsWe observed 11 patients with acquired deformities (AD) that required surgical correction.ResultsAD of the chest can be classified into 4 groups: (1) AD resulting from a pathological process within the thorax (heart enlargement, mediastinal tumors), (2) AD resulting from chest wall disease (rib osteomyelitis or tumors), (3) iatrogenic deformities (following rib graft harvesting, acquired Jeune's syndrome), and (4) post-traumatic deformities. Group 1 requires treatment of the pathological process. Group 2 is guided by oncological or infectious disease principles. Groups 3 and 4 require chest wall reconstruction. Iatrogenic AD usually occur after pectus excavatum repair with rib cartilage extirpation in young patients, which results in a reduced, restricted thorax. Post-traumatic AD often have pathological chest wall mobility owing to pseudo-articulation of injured ribs.ConclusionsTo prevent AD formation and to protect thoracic growth and mobility, costosternal and costochondral junctions should be preserved during cartilage resection. Substernal suturing of the perichondrium should be avoided.

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