Congenital deformations of the anterior wall
Developmental anomalies of the anterior chest wall are most commonly associated with changes in the shape of the sternum and adjacent ribs. Two main types of such deformations are distinguished:
- Pectus excavatum (thorax infundibuliformis). This pathology is characterized by pronounced depression of the sternum and ribs inward. Visually, a characteristic depression resembling a "funnel" forms on the anterior surface of the chest.
- Pectus carinatus (thorax carinatus). Unlike the previous form, this involves protrusion of the sternum along with the ribs outward. As a result, the chest acquires a specific shape that resembles a wedge or a bird's keel in appearance.
Clinical significance and treatment tactics for deformations
The clinical presentation and consequences of deformations depend on the severity of the pathology. In mild cases, the changes are exclusively of a cosmetic defect nature. However, with pronounced skeletal changes, physical displacement of mediastinal organs is possible, which inevitably leads to the development of functional disorders.
The approach to treatment directly depends on the severity of the condition:
- Conservative therapy. Used for minor deformations. The basis consists of massage and physical therapy aimed at strengthening the muscular framework.
- Surgical treatment. Indicated in severe cases. The essence of surgical correction is the transection of the altered ribs and sternum. Afterward, the chest wall is placed in the correct anatomical position. Surgical sutures, special external braces, or implantable magnetic plates are used to fix the achieved result.
Rare malformations and spinal anomalies
In addition to isolated sternal deformations, combined malformations and pathologies associated with the spinal column occur.
Complete sternal cleft (fissura sterni) is a relatively rare developmental anomaly. Its clinical significance is due to the fact that it is extremely frequently combined with other severe conditions, such as congenital heart defects and ectopia cordis (displacement of the heart). Treatment of this malformation is exclusively surgical.
Kyphosis (kyphosis) in the context of chest pathology is caused by congenital spinal deformation. Like sternal deformations, kyphosis can manifest as a cosmetic defect, but in severe forms it causes serious functional disorders, including circulatory and respiratory disorders. If such functional disorders are present, the patient is indicated for surgical intervention — plastic surgery on the spine.
Class and exam questions
What is the difference between thorax infundibuliformis and thorax carinatus?
In thorax infundibuliformis (funnel chest), the sternum and ribs are depressed inward, forming a "funnel." In thorax carinatus (pigeon chest), they protrude outward in the shape of a wedge.
In which cases is surgery indicated for chest deformations?
Surgical correction is indicated in severe cases, especially when deformation leads to mediastinal shift and causes functional disorders.
What pathologies are frequently combined with fissura sterni?
Complete sternal cleft is rarely isolated; it is frequently combined with congenital heart defects and ectopia cordis.
What else to study on this topic
- Massage techniques and physical therapy for mild chest deformations
- Types of fixation devices (braces, magnetic plates) in thoracic surgery
- Pathophysiology of mediastinal shift
- Spinal plastic surgery for severe kyphosis
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