Keel chest
| Classification according to ICD-10 | |
|---|---|
| Q67.7 | Pectus carinatum Congenital chicken breast |
| ICD-10 online (WHO version 2019) | |
The keel breast or chicken breast ( Latin pectus carinatum ) is characterized by a keel-shaped protrusion of the breastbone , which can pose a psychologically stressful aesthetic problem for those affected - especially during puberty .
Colloquially , a non-existent expression of the pectoralis major muscle is also referred to as “chicken breast” ( Poland syndrome ).
root cause
It is assumed that the cause of the keel breast is an excessive growth of cartilage on the ribs, which causes the sternum to bulge . A precise mode of inheritance is not known; however, a familial accumulation of various chest wall deformities can be observed. In some families, deformities in the form of a keel chest as well as a funnel chest occur. Cartilage malformation is to be assumed with both chest wall changes and asymmetrical intermediate stages .
A keel chest can develop secondary
- Scoliosis with a strong rib hump
- Mucopolysaccharidosis
- Marfan's Syndrome
- Thoracic emphysema
- rickets
clinic
There is an asymmetrical protrusion of the breastbone or parts of it. In principle, there are no functional disorders of the heart or lungs. However, Scheuermann's disease is common .
therapy
In individual cases it may be sufficient to inform the patient or the parents of the child about the harmlessness of the finding . In the case of more pronounced degrees, the further procedure depends on the possible impairment of self-esteem . If there are no (subjective) problems, therapy is not appropriate.
Psychological care
Psychological support may be recommended to those patients who have only minor changes and who are therefore focused on the cosmetic problem . This is also recommended if the fear of the operation (still) outweighs with a pronounced funnel breast and great suffering .
Operative treatment
In the case of severe psychological stress ( and an objective finding), surgical correction is indicated. Here an analogous procedure is chosen as for the funnel breast .
Either parts of the ribs and the sternum are removed, or a metal bracket is implanted in the Nuss surgical technique, which presses the keel down. Before considering such an operation, you should get detailed information from the surgeon about the surgical procedure, any complications that may arise and the follow-up treatment. After the operation, a so-called follow-up treatment (AHB) can be carried out. This can improve mobility and lung function, reduce adhesions caused by scar formation, and reduce pain and swelling through physical measures.
Treatment by bandage
A pad is strapped around the chest to restore the sternum to its normal shape. As a result, the sternum is more or less pressed in depending on the setting. This form of treatment is more promising in younger children, as more body growth occurs.
literature
- Anton H. Schwabegger (Ed.): Congenital Thoracic Wall Deformities. Diagnosis, Therapy and Current Developments . Springer, Vienna / New York 2011, ISBN 978-3-211-99137-4 . doi: 10.1007 / 978-3-211-99138-1
Individual evidence
- ↑ a b c F. Hefti: Pediatric orthopedics in practice . Springer, 1998, ISBN 3-540-61480-X , p. 122.
- ^ Klaus Holldack, Klaus Gahl: Auscultation and percussion. Inspection and palpation. Thieme, Stuttgart 1955; 10th, revised edition ibid 1986, ISBN 3-13-352410-0 , p. 57.
- ↑ Department of Pediatric Surgery of the Erlangen-Nuremberg Clinic on archived copy ( Memento of the original from May 4, 2006 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ^ SA Haje, JR Bowen: Preliminary results of orthoptic treatment of pectus deformities in children and adolescents. In: Journal of Pediatric Orthopedics. 12, 1992, p. 795.
