Canavese Federico, Dimeglio Alain, Bonnel François, Corradin Marco, Pereira Bruno, Marcoul Amélie, Charles Yann Philippe
Service de Chirurgie Infantile, CHU Estaing Clermont-Ferrand, 1 Place Lucie et Raymond Aubrac, 63003, Clermont-Ferrand, France.
Pediatric Surgery Department, University Hospital Estaing, 1 Place Lucie-et-Raymond-Aubrac, 63003, Clermont-Ferrand, France.
Surg Radiol Anat. 2019 Mar;41(3):287-296. doi: 10.1007/s00276-018-2164-4. Epub 2018 Dec 17.
The thoracic spine, the chondral and osseous ribs, and the sternum together make up the thoracic cage. These elements are strictly correlated, although their growth is not synchronous. The purpose of this study is to provide a comprehensive data set of thoracic dimensions and non-invasive volumetric assessment in a large cohort of males and females from early childhood to young adult age.
In all, 622 healthy individuals (406 girls, 216 boys) aged 6-18 years were consecutively enrolled between 2006 and 2016. All had to be healthy with no history of spinal deformity, or any lung, cardiovascular, systemic or neuromuscular disease. The optical ORTEN system for trunk surface data acquisition was used to calculate thoracic cage volume (V) and perimeter (Pe), anterior-posterior depth (AP) and transverse diameter (TD), AP/TD ratio, sternal length (St), and T1-T12 distance (Tle) in all patients.
The overall average age was 11.1 ± 2.5 years (4-18) for girls and 11.0 ± 3.1 years (4-18) for boys. Average growth parameters were: standing height 146.2 ± 14.6 cm (103-172) for girls and 146.4 ± 20.0 cm (94-192) for boys, sitting height 75.4 ± 8.6 cm (61-91) for girls and 75.5 ± 10.3 cm (60-99) for boys, weight 37.6 ± 10.4 kg (16-65) for girls and 38.3 ± 14.3 kg (13.7-104) for boys, BMI 16.7 ± 3.7 (18.5-26) for girls and 17.0 ± 3.3 (18.7-34.3) for boys. At age 6-8 years: V was 52.5% of its final size in girls and 44.9% in boys; Pe was 80.2% its final length in girls and 76.8% in boys; St reached 68% of its final size in girls and 66.9% in boys; Tle reached 73.3% of its final length in girls and 71.2% in boys. At skeletal maturity, thoracic cage volume in boys was 19.4% greater than in girls (p < 0.05). AP/TD ratio remained < 1 in all age groups and did not differ between genders (p > 0.05).
Growth of the thoracic cage is shown to be a gradual process that is more linear than previously reported. Only small increases in annual growth rates were observed during the pubertal growth spurt. The most important events characterizing thoracic cage development occurred during the first few years of postnatal growth. The circular cross-section of the very young child's thorax reached adult-like proportions together with its ovoid shape before age 6 years.
胸椎、软骨肋骨和胸骨共同构成胸廓。这些结构紧密相关，尽管它们的生长并不同步。本研究的目的是提供一个关于从幼儿期到青年期的大量男性和女性胸廓尺寸及非侵入性容积评估的综合数据集。
在2006年至2016年期间，连续纳入了622名年龄在6至18岁的健康个体（406名女孩，216名男孩）。所有参与者均需身体健康，无脊柱畸形史，也无任何肺部、心血管、全身性或神经肌肉疾病。使用光学ORTEN系统采集躯干表面数据，以计算所有患者的胸廓容积（V）、周长（Pe）、前后径（AP）和横径（TD）、AP/TD比值、胸骨长度（St）以及T1 - T12间距（Tle）。
女孩的总体平均年龄为11.1±2.5岁（4 - 18岁），男孩为11.0±3.1岁（4 - 18岁）。平均生长参数如下：女孩的站立身高为146.2±14.6厘米（103 - 172厘米），男孩为146.4±20.0厘米（94 - 192厘米）；女孩的坐高为75.4±8.6厘米（61 - 91厘米），男孩为75.5±10.3厘米（60 - 99厘米）；女孩的体重为37.6±10.4千克（16 - 65千克），男孩为38.3±14.3千克（13.7 - 104千克）；女孩的BMI为16.7±3.7（18.5 - 26），男孩为17.0±3.3（18.7 - 34.3）。在6至8岁时：女孩的V达到其最终大小的52.5%，男孩为44.9%；女孩的Pe达到其最终长度的80.2%，男孩为76.8%；女孩的St达到其最终大小的68%，男孩为66.9%；女孩的Tle达到其最终长度的73.3%，男孩为71.2%。在骨骼成熟时，男孩的胸廓容积比女孩大19.4%（p < 0.05）。AP/TD比值在所有年龄组中均<1，且男女之间无差异（p > 0.05）。
胸廓的生长是一个渐进的过程，比先前报道的更具线性。在青春期生长突增期间，年生长率仅略有增加。胸廓发育的最重要事件发生在出生后生长的头几年。幼儿胸廓的圆形横截面在6岁前与其椭圆形形状一起达到类似成人的比例。
