Open repair of pectus deformities

A variety of malformations of the chest wall may be identified in childhood. The most common are the pectus excavatum and pectus carinatum deformities. Pectus excavatum is characterized by a prominent posterior depression of the body of the sternum. Ravitch reported his surgical repair technique, that involved excision of all deformed costal cartilages with their perichondriums, division of the xiphoid from the sternum, division of the intercostal muscle bundles from the sternum, and displacing the sternum anteriorly after transverse sternal osteotomy, using Kirschner wires or silk sutures for stabilisation. It was modified with the preservation of the perichondriums and intercostal muscle bundles, and later on with a retrosternal steel strut fixation. Pectus carinatum is the anterior protrusion of the sternum. Open repair technique for pectus carinatum is more or less a variation of the open repair technique for pectus excavatum. Although minimally invasive repair of pectus excavatum and carinatum has become quite popular in recent years, open repair of pectus deformities are successfully performed in many centers around the world with low morbidity, low cost, short limitation of activity and a good quality of life improvement.