Surgical correction of pectus excavatum for adults and adolescents.

As an operative procedure for the correction of funnel chest in adult and adolescents, a strut method using AO-plates was used. All of the concaved parts of the sternum, costae, and cartilages contributing to the formation of the deformity were osteotomized to mobilize and elevate the deformed part. A vertical plate was used for fixation of the transected sternum, and three transverse plates were used as the portions which are curved appropriately to remodel the reconstructing chest wall. These plates were removed twelve to eighteen months after implantation. To date, thirty-one patients have undergone this repair. For the first eight, a single transverse plate was used, however, re-retraction of the region around the transverse plate became evident in the long term follow-up. Therefore, two or three plates were inserted for an improvement. When three transverse plates were used, retraction at the costal arch was relieved. Although a second operation is required to removal of the plates, we hold the view that this is the most effective operative procedure for the correction of funnel chest in adults and adolescents.