Neves Sara C, Pinho A C M, Fonseca Jaime C, Rodrigues Nuno F, Henriques-Coelho Tiago, Correia-Pinto Jorge, Vilaça João L
a ICVS/3B's - PT Government Associate Laboratory, Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho , 4710-057 Braga , Portugal.
Comput Methods Biomech Biomed Engin. 2015;18(7):711-20. doi: 10.1080/10255842.2013.843675. Epub 2014 Jan 16.
Pectus carinatum (PC) is a chest deformity caused by a disproportionate growth of the costal cartilages compared to the bony thoracic skeleton, pulling the sternum towards, which leads to its protrusion. There has been a growing interest on using the 'reversed Nuss' technique as a minimally invasive procedure for PC surgical correction. A corrective bar is introduced between the skin and the thoracic cage and positioned on top of the sternum highest protrusion area for continuous pressure. Then, it is fixed to the ribs and kept implanted for about 2-3 years. The purpose of this work was to (a) assess the stresses distribution on the thoracic cage that arise from the procedure, and (b) investigate the impact of different positioning of the corrective bar along the sternum. The higher stresses were generated on the 4th, 5th and 6th ribs backend, supporting the hypothesis of pectus deformities correction-induced scoliosis. The different bar positioning originated different stresses on the ribs' backend. The bar position that led to lower stresses generated on the ribs backend was the one that also led to the smallest sternum displacement. However, this may be preferred, as the risk of induced scoliosis is lowered.
鸡胸（PC）是一种胸部畸形，由肋软骨相对于骨性胸廓骨骼生长不均衡所致，肋软骨将胸骨向前牵拉，导致胸骨突出。人们越来越关注使用“反向努氏”技术作为鸡胸手术矫正的微创手术方法。在皮肤和胸廓之间插入一根矫正棒，并将其放置在胸骨最高突出区域的上方以持续施加压力。然后，将其固定在肋骨上并保留植入约2至3年。这项工作的目的是：（a）评估该手术引起的胸廓应力分布，以及（b）研究矫正棒沿胸骨不同位置的影响。第4、5和6肋后端产生了较高的应力，支持了鸡胸畸形矫正引起脊柱侧弯的假说。矫正棒的不同位置在肋骨后端产生了不同的应力。导致肋骨后端产生较低应力的棒位置也是导致胸骨位移最小的位置。然而，这可能是更可取的，因为诱发脊柱侧弯的风险降低了。
