Hyung Joo Park1, Kyung Soo Kim2, Young Kyu Moon2, Sungsoo Lee3. 1. Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-Daero, Seocho-Gu, Seoul 137-701, Korea. Electronic address: hyjpark@catholic.ac.kr. 2. Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-Daero, Seocho-Gu, Seoul 137-701, Korea. 3. Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, College of Medicine, Yonsei University, 211 Eunjoo-Ro, Gangnam -Gu, Seoul 135-720, Korea.
Abstract
PURPOSE: Pectus bar rotation is a major challenge in pectus repair. However, to date, no satisfactory technique to completely eliminate bar displacement has been introduced. Here, we propose a bar fixation technique using a bridge that makes the bar unmovable. The purpose of this study was to determine the efficacy of this bridge technique. METHODS: A total of 80 patients underwent pectus bar repair of pectus excavatum with the bridge technique from July 2013 to July 2014. The technique involved connecting 2 parallel bars using plate-screws at the ends of the bars. To determine bar position change, the angles between the sternum and pectus bars were measured on postoperative day 5 (POD5) and 4 months (POM4) and compared. RESULTS: The mean patient age was 17.5 years (range, 6-38 years). The mean difference between POD5 and POM4 were 0.23° (P=.602) and 0.35° (P=.338) for the upper and lower bars, respectively. Bar position was virtually unchanged during the follow-up, and there was no bar dislocation or reoperation. CONCLUSIONS: A "bridge technique" designed to connect 2 parallel bars using plates and screws was demonstrated as a method to avoid pectus bar displacement. This approach was easy to implement without using sutures or invasive devices.
PURPOSE: Pectus bar rotation is a major challenge in pectus repair. However, to date, no satisfactory technique to completely eliminate bar displacement has been introduced. Here, we propose a bar fixation technique using a bridge that makes the bar unmovable. The purpose of this study was to determine the efficacy of this bridge technique. METHODS: A total of 80 patients underwent pectus bar repair of pectus excavatum with the bridge technique from July 2013 to July 2014. The technique involved connecting 2 parallel bars using plate-screws at the ends of the bars. To determine bar position change, the angles between the sternum and pectus bars were measured on postoperative day 5 (POD5) and 4 months (POM4) and compared. RESULTS: The mean patient age was 17.5 years (range, 6-38 years). The mean difference between POD5 and POM4 were 0.23° (P=.602) and 0.35° (P=.338) for the upper and lower bars, respectively. Bar position was virtually unchanged during the follow-up, and there was no bar dislocation or reoperation. CONCLUSIONS: A "bridge technique" designed to connect 2 parallel bars using plates and screws was demonstrated as a method to avoid pectus bar displacement. This approach was easy to implement without using sutures or invasive devices.
Authors: Mariela Dore; Paloma Triana Junco; Carlos De La Torre; Alejandra Vilanova-Sánchez; Monserrat Bret; Gaspar Gonzalez; Vanesa Nuñez Cerezo; Javier Jimenez Gomez; Jose Luis Encinas; Francisco Hernandez; Leopoldo Martínez Martínez; Manuel Lopez Santamaria Journal: European J Pediatr Surg Rep Date: 2018-02-20