Asymmetric deformation of the chest
The deformation of the chest in appearance can be funnel-shaped and keel-shaped. And both kinds can be symmetrical or asymmetric. Asymmetric deformation suggests uneven development of the chest in one of its halves. With asymmetric funnel-shaped deformation, the funnel angle is flat on one side and the bottom of the depression is offset with respect to the midline.
Carrying out the lateral radiograph of the chest, determine the amount of deformation. At the same time, the ratio of the smallest and largest distances between the ventral spine and the inner breast plate is looked at. Proceeding from the received indicators, 3 degrees of deformation are distinguished.
Clinical manifestations allow differentiation of deformation also in 3 stages:
- Compensated. It is manifested in the presence of a cosmetic defect in the patient. Do not lead to disrupted operation of the chest organs both at rest and during physical exertion.
- Subcompensated. Violation of the work of chest organs and complaints about the condition arise due to physical exertion.
- Decompensated. Even in a calm state( without physical exertion), the cardiovascular system is inadequate.
Correction of deformation is carried out promptly. For surgical treatment of funnel-shaped asymmetric deformation of the thorax, thoracoplasty is used. There are about 30 ways to carry out such an operational impact. These methods are divided into four groups according to the principle of fixation of the sternum and ribs:
- with traction,
- using - and autografts,
- using locks and metal spokes,
- without traction and retainers.
During such operations pectoral muscles are separated from the sternum and the ribs are used sternotomy, breast-nodiafragmalnuyu bundle and side portions of the aperture of the rib arcs on both sides, cutting off the xiphoid process to the rectus abdominis, clipping cartilaginous segments deformed edges on two sides and fixation. Ribs and sternum using various fixatives.
It is optimal to carry out such operations before the age of five. The earlier the deformity correction is carried out, the faster the development of the thorax will begin. This can warn the patient against respiratory and cardiovascular deformities in the future.
If asymmetric chest deformation is observed in children younger than 3 years of age, treatment should be non-operative. This is a torso massage course, exercise therapy strengthening the muscles of the abdomen and extensors of the back, respiratory gymnastics, kinesitherapy, electrostimulation of the muscles of the extensor muscles of the trunk, etc.
The corrected position should be supported by dynamic orthoses. Sleep of the child should take place in the supine position on the back with an embedded reclining roller under the top of the kyphosis of the chest.
Another common deformation is keel-like. It can also be asymmetric and symmetrical. But it occurs less often funnel-shaped. It is formed due to excessive growth of cartilage and their protrusion over the breastbone. The dimensions of the chest sagittal exceed the frontal, which leads to the formation of a crest along the chest wall from the front. Speaking above the breastbone, such a comb resembles the shape of a keel. Hence the name of the deformation. This deformation creates a cosmetic defect, and in terms of health - a child with this kind of deformation is easily tired with physical exertion and complains of an increased palpitations. Also, this breach in the chest strengthens the pneumatization of the lungs, leading in some cases to their emphysema.
Clinical examination may reveal except the comb spine kyphotic deformation of character. In patients often there is an intervertebral chondrosis. If the deformation is so strong that the body finds violations in the respiratory and cardiovascular systems, the patient is shown surgery.
This deformation, asymmetric and symmetric in a highly pronounced form, is treated promptly with the help of thoracoplasty.
