Jawish R, Rigault P, Padovani J P, Touzet P, Finidori G, Chaumien J P
Service d'Orthopédie-Traumatologie Infantile, Hôpital des Enfants Malades, Paris.
Rev Chir Orthop Reparatrice Appar Mot. 1992;78(1):38-44.
The authors have studied the result of 34 pectus excavatum, corrected by two surgical methods, followed up between 3 and 20 years: half of cases were treated by Judet's procedure, making turn over of anterior wall chest, with 35 per cent of good result. The other cases were treated by sternochondroplasty and internal fixation, with 88 per cent of good result. Early failures related to sternal non union and to infection, occurred in 53 per cent of Judet's procedure; eight of the 13 failures were managed by sternochondroplasty (7 cases) and Judet's procedure (1 case); followed by good results. Failure at further time was related to the young age of the patients at treatment, to the deficiency of fixation and early removal of material. Consequently, durable correction at long term was obtained, when treatment was performed by sternochondroplasty procedure, over 14 years of age, when many pins were used for fixing the correction, left in place for more than one year. In such cases, we didn't observe regression of result. When small residual deformities subsisted they were often masked by the development of the muscles in man, and breast in woman, providing acceptable aspect of chest.
作者研究了34例漏斗胸患者采用两种手术方法矫正后的结果，随访时间为3至20年：一半病例采用朱代手术（Judet's procedure），即翻转前胸壁，良好结果占35%。另一半病例采用胸骨成形术及内固定，良好结果占88%。朱代手术早期失败与胸骨不愈合及感染有关，占该手术的53%；13例失败病例中有8例通过胸骨成形术（7例）和朱代手术（1例）处理，随后结果良好。后期失败与治疗时患者年龄小、固定不足及材料过早取出有关。因此，当采用胸骨成形术治疗，患者年龄超过14岁，使用多根钢针固定矫正且留置一年以上时，可获得长期持久的矫正效果。在这些病例中，我们未观察到结果的复发。当存在小的残余畸形时，它们常被男性肌肉和女性乳房的发育所掩盖，胸部外观可接受。
