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"Systematic review of surgical treatment techniques for adult and pediatric patients with pectus excavatum". Journal of Cardiothoracic Surgery (Review). 9: 25. doi: 10.1186/1749-8090-9-25. PMC 3922335. PMID 24506826.
Pectus carinatum can also be caused by vitamin D deficiency in children due to deposition of unmineralized osteoid. Least common is a pectus carinatum malformation following open-heart surgery or in children with poorly controlled bronchial asthma. Pectus carinatum is generally a solitary, non-syndromic abnormality.
[1] [2] He also pioneered a new surgical procedure for correction of the chest wall deformities pectus excavatum and pectus carinatum, which became known as the Ravitch procedure. [1] Ravitch moved to New York City in 1952 as a professor of surgery at Columbia College of Physicians and Surgeons and as the director of surgery at Mount Sinai ...
Vacuum bell for pectus excavatum treatment, with hand pump (left) and measuring rod (right) An alternative to surgery, the vacuum bell, was described in 2006; the procedure is also referred to as treatment by cup suction. It consists of a bowl shaped device which fits over the caved-in area; the air is then removed by the use of a hand pump. [33]
Sydney A. Haje (16 February 1952 – 26 June 2012) was a Brazilian orthopedist, known internationally for his pioneering work on chest wall deformities including the creation of a conservative treatment protocol for the pectus carinatum and pectus excavatum conditions.
Pectus carinatum deformity = 2 (pectus excavatum or chest asymmetry = 1) Hindfoot deformity = 2 (plain pes planus = 1) Dural ectasia = 2; Protrusio acetabuli = 2; pneumothorax = 2; Reduced upper segment/lower segment ratio AND increased arm/height AND no severe scoliosis = 1; Scoliosis or thoracolumbar kyphosis = 1; Reduced elbow extension = 1
Additional factors may present in the form of winging of the scapula, scoliosis, breast bone prominence (pectus carinatum), breast bone depression (pectus excavatum). Muscle abnormalities may present as hypotonia (low muscle tone), which may lead to lordosis (increased hollow in the back) due to poor abdominal muscle tone.
A normal Haller index should be about 2.5. Chest wall deformities such as pectus excavatum can cause the sternum to invert, thus increasing the index. [6] [7] In severe asymmetric cases, where the sternum dips below the level of the vertebra, the index can be a negative value. [8]