Abstract

This study is a review of the early postoperative results in fifteen patients who diagnosed funnel chest and underwent the corrective surgical procedure by the sternal turnover[STO] or the sternocostal elevation[SCE] between January 1988 and February 1990. Thirteen among fifteen patients were male. Early eight patients were corrected by the STO and late seven patients by the SCE. Cosmetic result was excellent in one, fair in five, poor in two patients who received the STO and excellent in all patients corrected by the SCE. This unfavorable postoperative result in the STO group was due to the protrusion of inverted xiphisternal joint, the depression along the rejoined costal cartilages and forward tilting of the distal sternum. The lower vertebral indices measured on the lateral chest film were improved postoperatively from 0.42\ulcorner0.08 to 0.30\ulcorner0.05 in the STO group and from 0.31\ulcorner0.05 to 0.24\ulcorner0.03 in the SCE group. There was significant improvement in lower vertebral index in both groups, but it was difficult to compare the postoperative improvement between groups due to the different preoperative status. In the SCE group, the funnel index and the degree of depression measured on the computed tomography were significantly improved from 5.29\ulcorner1.72 and 3.11\ulcorner0.71 to 2.77\ulcorner0.46 and 1.63\ulcorner0.19[P<0.05], but there was no significant change in the degree of flatness postoperatively. This results suggest that sternocostal elevation is more cosmetic procedure than sternal turnover in children and in young adolescents whose funnel index measured on the computed tomography is low.

Keywords