Top problem: chest deformity in a teenager. Keeled and funnel chest deformities in a child: causes, treatment without surgery and massage

Chest deformity is a change in the shape of the musculoskeletal skeleton of the upper body. There are two main types of chest deformity in children: funnel-shaped and keeled. What is the cause of chest deformity in children, and what should parents do in case of such a diagnosis?

Types of chest deformities in children and health hazards

The health consequences associated with chest deformity in children depend on the type of deformity and its degree.

funnel deformity chest in children manifests itself in the sinking of the costal cartilages, resulting in the formation of a "funnel", or depression, in the center of the chest.

There are 4 degrees of funnel chest deformity in children, depending on the depth of the "funnel". With I degree of deformation (deepening no more than 2 cm), the child may not feel any symptoms of the disease at all. At higher degrees of deformity, the child may experience difficulty in breathing, shortness of breath, and some disturbances in the functioning of internal organs due to their compression.

At keeled chest deformity in children, the sternum protrudes forward in the form of a keel, to which the ribs are attached at a right angle. This deformity is often only a cosmetic defect. If the keeled deformity is pronounced, this can lead to problems in the functioning of the lungs, heart and other internal organs due to a violation of their relative position. In this case, it is necessary to conduct an examination and find out the features of the location and functioning of the internal organs of the child.

What can cause chest deformity in children?

Chest deformity in children most often it is a congenital disease and is formed even in the prenatal period, when the child is in the mother's womb. Scientists have not yet found the exact answer why the baby's chest is deformed. It is only known that the probability of the manifestation of this defect increases with:

negative heredity (the presence of this disease in the anamnesis of the mother or father of the child or their immediate family);
exposure to teratogenic factors (negative factors that affect the pregnant woman and the fetus and cause disturbances in its development, without affecting hereditary structures). These factors include transfer by the expectant mother infectious diseases, taking antibiotics and other chemicals, exposure to radiation, etc.

That is, expectant mothers need to follow standard recommendations: take care of yourself, do not contact with patients, use medications with caution, etc.

As for the acquired one, it can be caused by serious illnesses suffered by the child (rickets, scoliosis, pulmonary diseases, etc.) and injuries to the upper part of the body.

How is chest deformity corrected in children?

At chest deformities in children mildly conservative treatment is carried out, without surgical intervention. It consists in carrying out physiotherapeutic procedures, massage, therapeutic exercises and, if necessary, in wearing a child with special squeezing devices - orthoses and dynamic compression systems.

In more serious cases, children are prescribed surgery to correct the shape of the chest. Previously, it was believed that the younger the operated child, the better, since the ability of children's tissues to regenerate is much higher than that of a teenager or an adult. Therefore, operations to correct the shape of the chest were performed on babies as early as preschool age. However, now most doctors agree that early surgical correction of the shape of the chest can lead to abnormal growth of the ribs, recurrence of the disease and the need for a second operation. Therefore, surgeons recommend performing the operation no earlier than 10-12 years for boys and 12-13 years for girls.

Respiratory gymnastics and physiotherapy exercises for chest deformity in children

The first thing to do if a chest deformity is found in a child is to consult a doctor (orthopedic surgeon or a narrower specialist). If the specialist confirms that the defect does not pose a risk to the health of the child, parents can deal with the deformity of the child's chest on their own, namely, do breathing exercises and physiotherapy exercises with the child. These methods cannot completely correct the defect, but they can slow down its development.

Breathing exercises for chest deformities in children helps to correct the shape of the musculoskeletal frame, in addition, normalizes the work of the heart and lungs. Before practicing breathing exercises with a child, you should check with the doctor - are there any contraindications to these exercises?

Breathing exercises

1. Holding your breath. Stand straight, feet shoulder-width apart. Take a deep breath and hold your breath for as long as possible. Then exhale sharply through the mouth. Repeat 5-10 times.

2. Upper breathing. Can be performed both standing and sitting. Inhale slowly and deeply, making sure that the stomach remains still and the chest rises. Exhale sharply through the mouth, repeat 5-10 times.

3. Expansion of the chest. Stand up straight, take a deep breath, clench your fists and extend your arms in front of you at shoulder level. With a quick movement, take your hands back and smoothly return to the starting position. Repeat several times and exhale sharply through your mouth. During the exercise, the muscles of the hands should be very tense.

In addition to breathing exercises, it is very useful for children with chest deformity to perform exercises for the development of pectoral muscles: push-ups, pull-ups, exercises with dumbbells and an elastic gymnastic tape. Strong muscles of the chest will help slow down the deformation and even stop it, in addition, the developed muscular frame will visually correct the cosmetic defect, “close” the deformed chest.

Swimming is very useful for children with a deformed chest - this sport helps the development of the pectoral muscles and lungs and at the same time has very few contraindications. Volleyball, basketball and rowing are also often recommended for this disease, especially if the child shows interest in them.

Mild chest deformity in children usually does not affect their health, especially if parents take measures to correct the defect: they do breathing exercises with the child, teach him to play sports. And even if the degree of deformation is high, medicine offers effective ways to completely eliminate the defect, ranging from high-tech compression devices to modern operations with minimal intervention. We wish your children good health and good mood!

Chest deformity in children is not uncommon. Two types of distortion are widespread. The first type is a depressed or sunken chest, which is caused by the sternum (the bone in the middle of the chest) sinking in abnormally. This type is better known as the "funnel chest". The second type of deformity is caused by the sternum sticking out like the keel of a boat; this condition is called "chicken breast".

funnel chest

Statistics show that about 1 in 300 children have pectus excavatum, which is either a birth defect or develops within the first few months after the baby is born. If a case of a mild defect corrects itself, this usually happens by the age of three.

However, in moderate to severe cases, the funnel-shaped depression can progress, and then surgery is most often required.

Chest deformity in children of the first type, no treatment is required. In a child with difficulty breathing, there is usually a periodic retraction, in some newborns and small children, when they inhale air, small or medium-sized depressions appear in the center of the chest, which disappear when they are exhaled. When examining a child with a funnel-shaped chest in a sitting position, lying on his back, straightened up, the cavity on the chest does not change, i.e. is rigid. In children who underwent surgery, breathing is restored and normalized. Treatment gives excellent results, 90-95% of children are helped by one operation; Approximately one in 30 pro-operated patients may need a second operation.

chicken breast

This type of chest deformity in children is three times less common than funnel chest.

Three out of four cases of chicken breast occur in boys. In girls, chicken breast, unfortunately, develops at an earlier age than in boys. In them, it usually develops only in adolescence, not earlier than 11-14 years.

Both in the first and in the second case, these violations affect the health of the child. This developmental disorder often leads to the development of emphysema (a chronic lung disease that manifests itself as respiratory failure and prevents gas exchange in the lungs at an early age, which increases every year until the child grows up). Patients with chicken breast symptoms often have scoliosis, which is more manageable after treatment. It can be treated with surgery, and the prognosis for babies who have undergone this operation is excellent.

Simultaneous occurrence of both types of disease

In fact, it is still unclear why children develop both types of chest deformity. But it was noted that both diseases recur with a frequency of about 65%, in certain families. In both conditions, there are: overgrowth and anatomical defects in the cartilage of the ribs and sternum (dense elastic tissue). If your child has a chicken breast, then it is usually combined with premature fusion of the sternum segments or a short and wide sternum, or congenital heart disease.

The symptoms of funnel chest usually appear after the age of seven. This defect makes it difficult for the child to breathe. If you have symptoms of the disease in early infancy, then this is usually associated with repeated long-term respiratory viral infections, often turning into pneumonia. Funnel chest deformities can actually vary greatly. The depression can be either wide and shallow, deep and narrow, or asymmetrical. One-sided, usually right-sided, retraction of the sternum is not uncommon.

Older children are inactive, get tired quickly, it is difficult for them to breathe with significant physical exertion and sports. For them, chest pain is a common occurrence and they are much more likely to suffer from respiratory diseases than healthy children of the same age. Approximately 20% of sick young men suffer from a lateral curvature of the spine and the absence of a bend in the upper back (the so-called straight back), they have crooked shoulders and a wide, thin chest.

With chicken breast, there are rarely any other symptoms, except for difficulties in games and physical exercises, soreness and periodic pain in the area of overgrown cartilage and increased suspiciousness.

In especially severe cases of pectus excavatum, the ability of the heart to pump blood is impaired, the function of the left lung is weakened, and, in addition, scoliosis may appear at any age.

Treatment

If your child has moderate to severe pectus excavatum, the only treatment is surgery, best at 3-5 years of age. If the operation is carried out in adolescence, then improvement in lung function may not be achieved. Children under two years of age should not be subjected to corrective surgery.

Surgery is necessary for most children with chicken breasts, as this bulge continues to increase with age until late adolescence.

The health of the child is the most important thing for parents. They worry about their child not getting sick, full of vitality and energy. But there are situations when a child gets sick, and this affects the whole family. In such cases, you need to contact specialists in time who can provide qualified advice. Serious diseases that require professional help in the treatment include chest deformity in a child. Parents should take this disease very seriously and immediately contact the clinic.

What is chest deformity?

The human chest is a kind of shield that supports and protects vital organs. It is also a musculoskeletal frame to which the ribs are attached. If a situation arises when a child has a deformity of the chest, then this entails serious consequences. Deformation can be both congenital and acquired. It negatively affects the work of all internal organs. It is worth recalling that the chest is designed to protect the heart, lungs, liver, spleen. And if there is a violation in one organ, then the entire life support system suffers.

Congenital deformity is also called dysplastic. It is important to know that such forms are much more common than acquired ones. Violations of bone structures occur, their formation in the womb, anomalies of the spinal column develop. Most often, changes are noted in the front of the chest of the child. Acquired deformities arise from a variety of diseases that can affect a person at any age.

Disease types

All chest disorders that are known to specialists can be combined into two large groups. These are such deformities as congenital and acquired. But within each group there is its own classification. Also, depending on the location, the child's chest deformity has several forms. It is believed that it can be front, side and back. According to the degree of violation, the disease is often implicitly expressed, even almost imperceptible until the appearance of serious pathologies that affect the functioning of the heart and lungs.

Congenital deformities are divided into the following types:

Funnel-shaped, in the common people this type of violation is called the "shoemaker's chest."
Keeled, or "chicken breast".
Flat.
Cleft.

Acquired disorders are divided into:

emphysematous.
Paralytic.
Kyphoscoliotic.
Scaphoid.

It should be noted that with congenital deformities of the chest, most often violations occur on its anterior wall. If it is an acquired deformity, then both the lateral and posterior surfaces may be disturbed. It is also necessary to know that if there is a congenital deformity of the chest in a child, its treatment is most often surgical.

Causes of the disease

When a child falls ill, parents try to find out the causes of the illness. In such cases, it is better to prevent the disease than to treat it for a long time. To find out why a chest deformity occurs in a child, you need to understand the etiology of the disease.

As already known, the deformation is congenital and acquired. Causes of congenital deformity:

Genetic predisposition (heredity).
Underdevelopment of bone tissue in the womb.

These are one of the most common causes of congenital deformity. You should also be aware that underdevelopment of the baby's bone tissue may occur because the mother suffered infectious diseases in the first trimester of pregnancy. The congenital deformity of the chest can be influenced by the lifestyle of the expectant mother, insufficient intake of nutrients by the embryo, and the presence of bad habits in the parent. The latter should include alcohol, smoking and the use of narcotic substances, as well as an important factor is the untimely appeal for help to specialists.

Causes of acquired disorders

Why does acquired chest deformity appear in a child? The reasons that provoke it are listed below:

Diseases of the musculoskeletal system.
Tumors.
Chondrosis.
Inflammatory and purulent diseases of soft tissues.
Various injuries.
Unsuccessful surgeries.
Excessive physical activity.
Metabolic disease.
Achondroplasia.
Bone anomalies.
Down Syndrome.
Asthma.
Bechterew's disease.
Inflammatory diseases.
Wife Syndrome.

All these diseases lead to serious consequences, and eventually deform the chest.

funnel deformity

Funnel-shaped deformity is also called sunken chest. This is one of which is revealed at birth. In newborns, doctors record about one case in four hundred children. This disorder is several times more common in boys than in girls. The reason for it is that the cartilage connecting the ribs is underdeveloped. Outwardly, the violation is presented as depressions in the upper and lower parts of the sternum. The chest is slightly enlarged in the transverse direction and, accordingly, the side walls have a curvature.

With the growth of the child, the violations are aggravated, the ribs begin to grow and tighten the sternum inward. All this leads to the fact that the heart and large arteries continue to shift and squeeze. If the child is a newborn, such deformation is almost imperceptible. It is visible only during long-term observation, when inhalation occurs. With a visual examination, changes in the chest will be noticeable only by the age of three. From this moment on, the child becomes painful, he is affected by frequent colds, and there are problems with pressure. The depth of the funnel can reach ten centimeters.

The occurrence of the disease

If a child has a deformity of the chest, and it manifested itself at an early age, doctors identify several theories of its formation. One of them says that the ribs and cartilage develop faster than the sternum, and because of this they displace it. Other authors are of the opinion that the violations occurred from intrauterine pressure, which displaced the back wall of the ribs. This theory also includes anomalies of the diaphragm with the addition of rickets. Another theory says that the funnel-shaped deformity arose due to pathologies of the connective tissues.

Also, deformation can manifest itself in several defects, both not too obvious and pronounced. It all depends on the factors influencing it:

A sternum with a degree of posterior angulation.
Costal cartilage, having a degree of posterior angulation at the point of attachment to the ribs.

Do not forget that the disease can also be aggravated by various anomalies of the diaphragm, which makes treatment difficult. Doctors also have several methods that help determine the severity of the disease. This is a quantitative calculation of the distance from the sternum to the ribs.

Keeled deformity in a child

In terms of the prevalence of deformations, the keeled one is in second place. It occurs with a large and rapid growth of costal cartilage. The shape of the sternum becomes like a bird's chest as it protrudes forward. Many parents have questions about what is chest deformity in a child? Causes and treatment (photos of patients are presented in this article) will be discussed in detail.

Keeled deformity in a child becomes more noticeable with age and develops as a pronounced pathology. But it is worth noting that with such violations of the musculoskeletal system, the internal organs do not suffer. Symptoms such as shortness of breath and palpitations may be observed. As for the spine, it does not undergo changes. Most often, the disease affects boys. Sometimes the disturbances are asymmetrical, with indentation on one side and bulging on the other.

Causes of the disease

The etiology of such a violation is not entirely clear, as in the case of funnel-shaped deformity. It is believed that the cause is the overgrowth of osteochondral cartilage. In turn, it all depends on heredity and genetics. If relatives had such a disease, then it is possible that it was transmitted to the child. It is important to remember: if a child has a deformity of the chest, only experienced specialists will tell you how to fix this problem.

There is also an opinion that the deformation is caused by scoliosis and also by anomalies of the connective tissue. Most often, doctors divide this disease into three types:

The sternum and ribs are symmetrical, but shifted down.
The sternum is shifted down and forward, a protrusion is observed. The ribs in this case are bent.
The costal cartilages bulge forward, but there is no sternum disturbance.

Symptoms of the disease appear already in adolescence, but they are slightly pronounced. Sometimes the symptoms are clearly manifested during heavy physical exertion. It also contributes to the development of asthma.

The child has a deformity of the chest: how to treat?

The methods of treatment are varied - it all depends on the degree and also on whether there are disorders in the cardiovascular and respiratory systems. If the violations are minor, then conservative treatment can be chosen. Parents who are worried about the health of their children often ask questions to a specialist: “If a child has a chest deformity, what should I do?” In such cases, it is important to listen to the opinion of doctors and not make hasty decisions. After all, the child's body is still developing, and with improper treatment, the clinical picture will worsen. In certain cases, doctors recommend surgery. Here the diagnosis of the disease plays a special role.

Diagnostics

To date, there is a large supply of methods for studying disorders of the musculoskeletal system. One of the most common is radiography. It gives a complete picture of the disorders and, with the correct description of the images, can contribute to the effectiveness of the treatment. With the help of x-rays, you can get data on the degree and form of deformation of the chest.

Another instrumental method is CT of the sternum. It allows you to determine the degree of disorders that affect the heart and lungs, as well as the degree of displacement of the internal organs. Along with CT, another hardware method is used - MRI. It gives complete and detailed information about the bone, connective tissues, their condition and the degree of development of the disease. There are also additional methods that can describe the clinical picture. These include ECG, echocardiography and spirography. They make it possible to determine the state of internal organs.

Chest deformity in children: treatment at home

If the disease does not require surgical intervention, then conservative methods of treatment are perfect. So, parents at home can help their child on their own. Such treatment includes the following:

physiotherapy - moderate physical activity and the development of bone tissue will help when there is a slight deformation of the chest in a child;
massage treatment by a specialist;
physiotherapy exercises prescribed by a doctor;
Swimming is a great way to develop the musculoskeletal system and lift your spirits.

Chest deformities in children

Chest deformities in children are congenital or early acquired curvature of the sternum and the ribs that articulate with it. Chest deformities in children are manifested by a visible cosmetic defect, disorders of the respiratory and cardiovascular systems (shortness of breath, frequent respiratory diseases, fatigue). Diagnosis of chest deformity in children involves thoracometry, radiography (CT, MRI) of the chest, spine, sternum, ribs; functional studies (RF, EchoCG, ECG). Treatment of chest deformity in children can be conservative (exercise therapy, massage, wearing an external corset) or surgical.

Symptoms of chest deformities in children

The clinical manifestations of pectus excavatum vary with the age of the child. In infants, the depression of the sternum is usually hardly noticeable, however, there is a "paradox of inspiration" - the sternum and ribs sink down when inhaling, when the child screams and cries. In younger children, the funnel becomes more prominent; there is a tendency to frequent respiratory infections (tracheitis, bronchitis, recurrent pneumonia), fatigue in games with peers.

Funnel chest deformity reaches its greatest severity in children of school age. On examination, a flattened chest with raised edges of the ribs, lowered shoulder girdle, protruding abdomen, thoracic kyphosis, and lateral curvature of the spine are determined. The "paradox of inhalation" is noticeable with deep breathing. Children with pectus excavatum have low body weight and pale skin. Characterized by low physical endurance, shortness of breath, sweating, tachycardia, pain in the heart, arterial hypertension. Due to frequent bronchitis, children often develop bronchiectasis.

Keeled deformity of the chest in children is usually not accompanied by serious functional disorders, so the main manifestation of the pathology is a cosmetic defect - protrusion of the sternum forward. The degree of chest deformity in children may progress with age. When the position and shape of the heart changes, complaints of fatigue, palpitations and shortness of breath may occur.

Schoolchildren with chest deformity are aware of their physical handicap, try to hide it, which can lead to secondary mental layers and require help from a child psychologist.

Poland's syndrome or rib-muscular defect includes a complex of defects, including the absence of pectoral muscles, brachydactyly, syndactyly, amastia or atelius, deformity of the ribs, lack of axillary hair growth, and a decrease in the subcutaneous fat layer.

The cleft of the sternum is characterized by its partial (in the area of the handle, body, xiphoid process) or total splitting; at the same time, the pericardium and the skin covering the sternum are intact.

Causes

Most often, this pathology is congenital, scientists have the following theories of its appearance:

1. When bone and cartilage formations grow unevenly in the chest area, because the embryo lacks certain substances in the womb. At the same time, the chest begins to form unevenly, its circumference, shape, size change, it is quite flattened.

2. Funnel-shaped deformity is associated with a congenital pathology of the diaphragm - the thoracic part lags behind in development and is shortened. The ribs are strongly inclined, because of this, the muscles of the chest change their position, the anterior part of the diaphragm is attached to the arches of the ribs.

3. The funnel-shaped chest is deformed due to the fact that the sternum is incompletely formed in utero, then dysplasia appears in the connective tissues, this affects the cardiovascular, respiratory system, the metabolic process is disturbed. The additional features are:

violations in the cuts of the eyes, they have a Mongoloid appearance;
the child's sky is high;
the skin is hyperelastic;
scoliosis, umbilical hernia, ear dysplasia develop;
weakened sphincter.

4. Genetic predisposition of the child to this deformation.

Modern scientists believe that the disease is provoked by an early embryonic developmental deficiency - in the first eight weeks, when the cartilaginous rib cells and the sternum do not fully develop, because of this, the child has a congenital pathology, the cartilage that was still in the embryo is preserved, it is fragile, soft tissue.

Treatment of chest deformities in children

Conservative treatment is prescribed for sunken chest. In this case, treatment depends on the degree of retraction of the sternum. At 1 and 2 degrees, therapeutic exercises are prescribed. The main emphasis should be placed on the chest - push-ups, pull-ups, spread dumbbells in the prone position, etc. The child can go in for swimming, volleyball, rowing. These sports allow you to delay the deepening process. In addition, therapeutic massage will be effective.

In a complicated case, surgical intervention is performed. The operation is performed on the child only after 6-7 years. It is at this age that the defect ceases to form. In other cases, the operation is done early.

An incision is made in the child's chest, where a magnetic plate is inserted. A belt with a magnetic plate is put on the chest area. Magnets are attracted to each other, so sunken breasts can be corrected in 1-2 years.

If the changes are acquired, then the child is first examined for diseases that could cause deformity, and only then conservative treatment or, if necessary, surgery is performed.

Treatment of keeled chest deformity in children begins with conservative measures: exercise therapy, massage, therapeutic swimming, wearing special compression systems and children's orthoses.

Surgical correction of the keeled chest is indicated for a pronounced cosmetic defect and progression of the degree of deformity in children older than 5 years. Various methods of thoracoplasty include subperichondral resection of the parasternal parts of the ribs, transverse sternotomy, repositioning of the xiphoid process, and subsequent fixation of the sternum in its normal position by suturing it to the perichondrium and ends of the ribs.

With a funnel chest, conservative measures are indicated only for the I degree of deformation; at II and III degree, surgical treatment is necessary. The optimal period for surgical correction of the funnel chest is considered to be the age of children from 12 to 15 years. In this case, the fixation of the corrected position of the anterior chest can be carried out using external sutures made of metal or synthetic threads; metal clamps; bone auto- or allografts left in the chest cavity, or without their use.

Special thoracoplasty techniques have been proposed for the surgical correction of cleft sternum and costo-muscular defects.

The results of chest reconstruction in children with congenital deformity are good in 80-95% of cases. Relapses are observed with inadequate fixation of the sternum, more often in children with dysplastic syndromes.

Under the deformation of the chest understand the change in the shape and size of the chest. It can be congenital and acquired, but always has a negative effect on the internal organs. Deformed breasts are a fairly common problem in our time and occur in 1-2 people per thousand.

Types and classification

There are 2 main types of breast deformities: congenital (dysplastic) and acquired. The latter may be the result of injuries, inflammatory pathologies and surgical interventions on the heart, lungs and other organs of the chest cavity. Sometimes a distortion of the shape of the breast causes thoracoplasty (removal of one or more ribs) due to some kind of congenital deformity.

Acquired deformity of the chest can develop after purulent diseases of the organs of the chest cavity or wall - for example, purulent pleurisy, cavernous tuberculosis, osteomyelitis, rickets, etc. On the side of the lesion, in this case, the circumference of the chest is greatly reduced, and the intercostal spaces narrow. As a result, the spine is bent in the thoracic region.

It should be noted that such deformities that occur against the background of infectious and inflammatory processes are extremely rare. This is explained, firstly, by the timely detection of dangerous diseases, and secondly, by the effectiveness of modern antibacterial therapy.

Post-traumatic deformities are possible after fractures of the ribs, body or handle of the sternum. In childhood, such injuries are quite easily corrected due to the softness and mobility of the skeleton, which cannot be said about adults.

In young children, the cause of the development of deformity may be rickets that occurs during intensive growth. This disease is accompanied by a disorder of bone formation and insufficient mineralization of bones due to lack of calcium. With rickets, the chest expands in an anterior-posterior size, its lower edge retracts, and the body and xiphoid process of the sternum move forward, resembling a keel. Therefore, such a deformation is called keeled.

Navicular depression is another type of sternum deformity that occurs very rarely. Its cause is syringomyelia disease, which affects the spinal cord. The bones lose their rigidity and are bent in the upper and middle parts of the chest.

Acquired deformity of the chest in adolescents may be the result of curvature of the spine - scoliosis. In adults, the configuration of the chest can change with pulmonary emphysema: due to expansion in the anterior-posterior direction, the chest becomes barrel-shaped.

Among congenital deformities of the chest, funnel-shaped deformity is most common, and keeled is somewhat less common. Rare types of deformities include Poland's syndrome and Gen's syndrome, as well as sternum defects associated with an atypical location of the heart.

Congenital deformity of the chest in a child (CHD)

With congenital deformities, the shape of the anterior surface of the chest changes, there is an underdevelopment of the sternum, ribs or muscles. Often, some ribs may be completely absent. In the vast majority of cases (more than 90% of all chest deformities), funnel-type breast curvature is diagnosed.

The funnel-shaped chest is the retraction of the anterior sections of the sternum inward. The exact cause of this defect has not been established. However, there is no doubt about its genetic origin, which is confirmed by the presence of the same pathology in close relatives of patients. In addition, very often funnel-shaped deformity is accompanied by other malformations.

The immediate cause is cartilage and connective tissue dysplasia, which can manifest itself not only before the birth of the child, but also in the process of its further growth. With age, the pathology often progresses and leads to negative consequences:

curvature of the spine;
reduction in the volume of the chest cavity;
displacement of the heart;
dysfunction of internal organs.

Congenital pectus excavatum (cobbler's chest) occurs predominantly in newborn male infants

There are 3 degrees of funnel deformity. To determine them, it is necessary to measure the size of the depression. If it is less than 2 cm, this is 1 degree, at which the heart is not displaced.

When the funnel size is from 2 to 4 cm, they speak of 2 degrees of deformation, the shift of the heart in this case is no more than 3 cm. The last 3 degree is characterized by a depth of the funnel over 4 cm and a displacement of the heart by more than 3 cm.

In newborns and children up to a year, funnel-shaped deformity is almost invisible. The only sign of an anomaly is the so-called paradox of inspiration - an increase in the retraction of the sternum and ribs during inspiration.

However, the curvature gradually progresses, reaching its maximum by the age of three. In children, there is a lag in physical development, disruption of the autonomic nervous system and frequent colds. In the future, the depth of the funnel increases more and more and can reach a size of 7-8 cm.

Keeled deformity is 10 times less common than funnel deformity and is characterized by excessive growth of costal cartilages, usually 5-6 ribs. The chest protrudes forward in the middle and becomes like a boat keel.

As the child grows, the shape of the sternum becomes more and more distorted and represents a significant cosmetic defect. From the side it may seem that the chest is in a state of constant inspiration.

It should be noted that with keeled deformity, the spine and chest organs practically do not suffer. The heart takes the form of a drop - its longitudinal axis greatly increases in comparison with the transverse one.

The main complaints of patients are shortness of breath, fatigue, palpitations during physical exertion.

Chest deformity in adolescents

Parents often notice a change in the shape of the breast in adolescents by accident. For no apparent reason, a depression suddenly appears in the center of the chest, or, on the contrary, the bones begin to bulge. Most often this happens at the age of 11-15 years, when the child is growing rapidly.

Funnel-shaped deformity has especially striking symptoms: the chest flattens, the edges of the ribs rise, the shoulders fall, and the stomach protrudes. Due to the deformation of the bones, the spine curves in the anterior-posterior (kyphosis) or lateral directions (scoliosis).

Keeled deformity looks like a bulging of the lower part of the sternum outward, and the edges of the ribs inward. Severe curvature is eliminated exclusively by surgery.

During a deep breath, the anterior chest sinks even more (inspiration paradox), and a number of typical signs are noted:

low body weight that does not correspond to the age norm;
palpitations and pain in the region of the heart;
increased sweating and blood pressure;
pallor of the skin;
low physical endurance;
frequent bronchitis.

The deformation of the sternum in schoolchildren delivers not only physical inconvenience and ailments, but also negatively affects the fragile psyche. Adolescents are aware of their physical defect and are ashamed of it, trying their best to hide it.

How to fix chest deformity

Chest deformities are treated by surgeons, orthopedists and traumatologists. The choice of technique is influenced by 2 factors: the cause and stage of the curvature. If there is no compression of the internal organs and the pathological process is detected at an early stage, a conservative approach is possible.

Therapeutic techniques may include the use of a vacuum bell, gel injections, exercise therapy, and massage. Each of these methods has its limitations and does not always guarantee a lasting effect.

Vacuum bell - a vacuum bell - is successfully used in both children and adults (with small deformations)
It is possible to treat keeled deformity with the help of a special corset, but only in the early stages. Wearing an orthopedic orthosis is justified in children: the child's body quickly adapts to external influences.

Important: the disadvantage of orthopedic corrective devices is that they cannot be worn for a long time. Such structures are very bulky and heavy.

Operation

Surgical correction of pectus excavatum includes about 50 options that differ in the way they are stabilized. Operations can be performed with external, internal fixators or without them. There are also techniques for flipping the sternum by 180° - for example, free flipping of the sternocostal complex or flipping on a muscular pedicle with preservation of the vascular bundle. For shallow recesses of 1-2 degrees, artificial implants are used.

The most promising direction of surgery is currently considered to be operations during which special plates are installed inside the patient's body. Such interventions are the least traumatic and quite easily tolerated, and also allow to shorten the rehabilitation period as much as possible.

The choice of method is carried out taking into account many parameters, but primarily depends on the degree of deformation and its effect on the functioning of internal organs. The task is greatly facilitated if the defect is purely cosmetic in nature, which does not create additional problems.

In recent years, an operation using minimovers - magnets has been actively developed and introduced into clinical practice. One magnet is installed in the patient's chest, and the second is sewn into a special belt. Correction of a defect takes an average of about two years.

Physiotherapy

Chest deformity in children, detected at an early stage, responds well to conservative treatment. Performing special exercises helps maintain the normal functioning of the respiratory and cardiovascular systems, helps prevent displacement of organs and curvature of the spine.

Physiotherapy exercises are conducted by an exercise therapy instructor who, based on the patient's data, selects the necessary exercises and subsequently evaluates their effectiveness. Gymnastics is also carried out in the rehabilitation period after surgical interventions.

The gymnastic complex may include the following exercises:

walking of varying degrees of difficulty for 2-3 minutes;
in a standing position, feet shoulder-width apart, raise your arms up as you inhale and lower as you exhale;
take your hands back and fold your hands into the castle. Slowly take your shoulders back, while raising your hands behind your back and bringing your shoulder blades together as much as possible;
it is very useful to do exercises with a gymnastic stick (body bar). Bring the stick behind your back and place it at the top of your shoulder blades, holding the ends. Walk with your knees high
bike. Lying on your back, straighten your legs in turn, without lowering them to the floor. The effect will be enhanced if the head and shoulders are also in weight, and the hands are on the back of the head;
standing on all fours, alternately raise the left, then the right hand. When performing, you need to make sure that there is no deflection in the lower back.

Thus, there are many treatment options for chest deformities. Conservative methods are effective mainly in young children. In the vast majority of cases, it is possible to correct a defect in adolescents and adults only with the help of surgical intervention.