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At least 1,423 records · Page 79Linked to original sources
PubMed2002

Flail chest secondary to excessive rib resection in idiopathic scoliosis: case report.

STUDY DESIGN: Case report. OBJECTIVES: To report a previously undescribed complication of scoliosis surgical treatment. SUMMARY OF BACKGROUND DATA: None available. METHODS: Clinical case analysis. RESULTS: Excessive rib resection resulted in a permanent "flail" chest. CONCLUSION: Rib resection ("costoplasty") is a valuable procedure for obtaining bone graft and for esthetic reduction of rib prominence, but excessive removal and especially done twice can produce major disability.

Adolescent↗
PubMed2005

Fusionless scoliosis surgery.

PURPOSE OF REVIEW: Severe spinal deformity in young children is a formidable challenge for optimal treatment. Standard interventions for adolescents and adults, including spinal deformity correction and fusion, may not be appropriate for young patients with considerable growth remaining. Alternate surgical options that provide deformity correction and protect the growth remaining in the spine are needed to treat this population of patients best. RECENT FINDINGS: Several groups have reported very exciting advances in the field of deformity spine surgery. Updated findings concerning the successful implementation of growing rods have revived this technique as a viable option for preserving near normal growth of the spine. New techniques have also been recently described, including vertebral stapling that produces asymmetric and corrective growth of the concavity of a deformity, and vertical expandable prosthetic titanium rib instrumentation that indirectly corrects spine deformity and protects spine growth remaining to treat an associated thoracic insufficiency syndrome. SUMMARY: New techniques and instrumentation at the disposal of spine surgeons allow the treatment of this challenging patient population to approach the goals of deformity correction and maintenance with preservation of potential growth. Preliminary outcomes from the different techniques are promising, but further investigation, including long-term follow-up, is necessary.

Child, Preschool↗
PubMed2004

Chest wall reconstruction using iliac bone allografts and muscle flaps.

Technically we can divide full-thickness thoracic reconstruction into 2 parts: providing a rigid support and ensuring well-vascularized coverage. Since 1986, the authors' center has had ample experience with bone banks and the use of cryopreserved bone grafts, which led them to consider the possibility of using these grafts for full-thickness chest wall reconstruction. They describe 3 patients in whom resection of the tumor and reconstruction of the thorax were carried out using iliac bone allografts covered with muscle flaps (1 pectoralis major and 2 rectus abdominis). None of the patients experienced breathing difficulties, pain, or instability after 14 months, 18 months, and 11 years of follow-up. The result of the reconstruction was excellent in all 3 patients in terms of function and aesthetics. The advantage of allografts compared with synthetic materials is their potential integration; they can become part of the host patient's living tissue.

Adult↗
PubMed1993

CT after reconstructive repair of the sternum and chest wall.

Acute mediastinitis and sternal infection after sternotomy are potentially devastating complications, but considerable advances in treatment have been made during the past decade. Sternectomy followed by reconstruction with use of either an omental transposition or a muscle flap has markedly decreased mortality and morbidity. After extensive rib resection, various reconstructive repairs, including the use of polytetrafluoroethylene mesh, have proved successful. The authors retrospectively reviewed 27 postoperative computed tomographic (CT) scans obtained in 19 patients. Twelve of these patients had sternal wounds repaired with either omental or muscle flap procedures. Seven patients had chest wall reconstructions with polytetrafluoroethylene patches, muscle transpositions, or both. The authors found no cases of unexpected or unexplained fluid collections on CT scans obtained beyond the 1st month. Any persistent or recurrent collection is suggestive of infection. If clinical and imaging findings are at odds, imaging-directed needle aspiration can help determine whether a fluid collection is infected and in need of further treatment.

Adult↗