Chest deformity: degree, cause, treatment. Funnel and keeled chest deformity
Chest deformity can be either congenital or acquired. It is accompanied by a significant change in shape. This pathology is considered very serious.
The chest is a kind of skeleton of muscles and bones. Its main task is to protect the internal organs of the upper torso. It is now established that the deformation of the chest has a negative effect on the heart, lungs and other organs. This pathology entails disruptions in the normal functioning of various systems.
General information about the Gizhitskaya index
This is an X-ray indicator, which is currently optimal.This index is used to accurately determine the degree of deformation of the chest. Thanks to him, experts can decide on the need for surgical correction.
All possible variants of this pathology are divided into two main groups. As mentioned earlier, the chest deformity can be both congenital (dysplastic) and acquired. The latter are much more common. Their development often occurs under the influence of the following factors:
- Bone tuberculosis.
- Severe injuries and burns of certain areas of the sternum.
- Chronic lung disease.
Any chest deformity (congenital) implies the presence of serious abnormalities or underdevelopment of the following areas:
- Shoulder blades
- The sternum.
- Chest muscle.
Less commonly, the most severe chest deformity occurs. The reasons lie in the presence of a significant disturbance in the development of bone structures.
Violations are divided into forms depending on the location of the pathology. There are deviations of the following walls:
Deformations can be very diverse. In some cases, this is a slightly noticeable cosmetic defect, while in others it is an incredibly gross apparent pathology. The latter most often causes significant disturbances in the functioning of the lungs and heart.
Features of congenital changes
In this case, the deformities of the anterior chest region are always observed. Often, the pathology is accompanied by a serious underdevelopment of the muscles. In some cases, the edges may be completely absent.
Funnel chest deformity
This pathology is accompanied by a noticeable recession of individual zones. These are, in particular, the anterior sections of the ribs, cartilage or sternum. This is a fairly common developmental defect. Funnel deformity of the chest often occurs due to the presence of serious genetic changes in the structure of cartilage and connective tissues.
Clinical picture at a younger age
This pathology very often becomes the cause of other ailments. Chest deformity in children occurs during their active growth. During this period, changes in the shape of the bones occur. In particular, it refers to the spine.Also, very often there are changes in the location of internal organs and violations in their work. Chest deformity in children is accompanied by multiple malformations. With regard to such cases, in the history of (family), you can identify several similar pathologies that are among the closest relatives. This disease is characterized by a clear retraction of the sternum. As a rule, its entire cavity is significantly reduced. If a patient has a pronounced funnel-shaped deformity of the chest (its treatment is quite complicated), then in this case, the spinal curvature is inevitable. There is a significant displacement of the heart, begin serious problems in the work of the lungs. Often there are dangerous changes in venous or blood pressure.
Stage of the disease
Modern specialists in traumatology distinguish them from all three:
- First degreeIn this case, the depth of the funnel does not exceed 2 cm. At the same time, the heart does not shift.
- Second degreeIt is characterized by the following depth of the funnel: 2-4 cm. At the same time, the heart is displaced (up to 3 cm).
- Third degree In this case, the depth of the funnel - from 4 cm and more. At the same time, the displacement of the heart exceeds 3 cm.
Features of the disease at an early age
In most infants, the presence of such a pathology is almost imperceptible. Only during inhalation there is a significant dropping of the ribs and sternum. Pathology becomes more pronounced as the child grows. In the future, it reaches its maximum. Very often, these children begin to lag significantly in physical development. Also, in most cases, serious autonomic disorders and colds become their companions.
With the subsequent development of deformity, the chest becomes fixed. The depth of the funnel can increase to 8 cm. The child begins to develop scoliosis. In some cases, thoracic kyphosis appears. There is a decrease in respiratory excursions of about three to four times, if compared with age norms. There are serious violations in the work of the cardiovascular and respiratory systems. Many children suffering from this pathology are asthenic. In most cases, the vital capacity of the lungs is reduced by 30%. Often marked manifestations of heart and respiratory failure. Gas exchange in the blood is very difficult.Children often complain of fatigue and pain behind the sternum.
This procedure consists of a whole complex of various studies. These include: radiography of the lungs, ECG and echocardiography. Focusing on the results of the above manipulations, experts can determine the extent of changes in the activity of the heart and lungs.
Features of therapy
At present, it has been proven that the use of modern conservative methods in the presence of this pathology is extremely inefficient. If the child has been diagnosed with severe chest deformity, surgery to reconstruct it helps to create normal conditions for the functioning of internal organs. This is a very serious surgical intervention. Usually, the operation is planned when the child is already six years old. If chest deformity is detected, exercise will not contribute to the complete deliverance of the patient from the pathology. Generally recommend the following:
- Hyperbaric oxygenation.
- Acupressure chest massage.
- Special physiotherapy exercises.
- Respiratory gymnastics.
All the above exercises must be performed. This is necessary in order to prevent the possible progression of pathology.
Keel-shaped chest deformity
Basically, this pathology is caused by the presence of excessive proliferation of the main costal cartilages. In this case, the sternum of the patient always comes forward. This is due to the fact that, as a rule, the growth of cartilage from 5 to 7 ribs occurs. For this reason, the chest takes the shape of a keel. In the presence of such a pathology, its anteroposterior size often increases. The child grows, and the deformation becomes more and more noticeable. There is a visible cosmetic defect. At this stage, the spine and all internal organs suffer slightly. The heart takes a teardrop shape. Many patients have the following symptoms:
- Fast fatiguability.
- Palpitations (with physical exertion).
- Severe shortness of breath.
If a child has severe keeled chest deformity, then surgical intervention is prescribed when there are disturbances in the functioning of the internal organs.Surgical manipulations are not shown to those children who have not yet reached the age of five.
Diagnostics and therapeutic interventions
The keel-shaped deformation is confirmed already during the initial inspection. The diagnosis is made by an orthopedic surgeon. Next, the patient undergoes x-ray examination. Thus, the type and degree of pathology present is determined. After that, the specialist selects the appropriate therapy. If the patient has confirmed the deformation of the chest, the treatment is not limited to respiratory and physical gymnastics. The fact is that often they cannot provide the necessary correction. This pathology is not exposed to physical therapy. However, the chest can become more supple thanks to swimming. As for the correction with the use of modern orthopedic devices, it is effective only at a fairly early age. In the most severe cases, specialists are forced to resort to surgical interventions. Keel-shaped deformation differs significantly from the funnel-shaped form, which is much more serious.The first does not have a significant impact on the work of all internal organs. The development of the spinal column is also generally stable. In some cases, there are disturbances in the functioning of the heart. As for modern surgical correction, it is carried out only if there are certain cosmetic indications.
In practice, there are various cases of violations of the development of the area in question. One of them is considered emphysematous chest. It is about increasing the airiness of the lung tissue. With this pathology, the shape of the chest gradually changes. This is due to the fact that the disease is accompanied by an increase in the lungs. There is a change in the anteroposterior size of the chest. It gradually increases. The chest of the patient becomes round.
Features of a paralytic form
This pathology is usually found in the presence of diseases of the pleura and lungs (chronic). In this case, the reduction of the organ. The same happens with the lateral and anteroposterior size of the chest. At the same time there is a dropping of intercostal spaces.Accordingly, it becomes difficult for patients to breathe. The scapulae and the clavicle are also clearly visible. This is due to the fact that their location relative to the sternum and ribs varies. The symmetry of the movements is broken.
Most often, this pathology is observed in patients with a rare disease. It's about syringomyelia. With this disease, cavities appear in the spinal cord. Pathology is characterized by a change in the composition of bones. This is due to the fact that calcium salts are leached from them. Bones can be deformed as they become less rigid. The disease is accompanied by a navicular indentation of the chest.
This form of deformity occurs due to spinal disorders. The disease may be due to the following phenomena:
- Spinal tuberculosis.
- Surgical interventions.
The appointment of optimal therapy
Most of these acquired pathologies are the result of chronic diseases. They do not pose a threat to the lives of patients. If the patient has congenital deformity of the chest, the treatment can also be successful. In this case, conservative methods are ineffective.Surgical intervention is prescribed when there is a violation in the chest organs. It can also be shown if there is a pronounced cosmetic defect.
Features of reconstruction
During the procedure, the sunken parts return to their places. They are fixed mechanically. In the presence of keeled deformity, the rib cartilage is truncated. In the case of this pathology, surgical interventions are performed less frequently. Currently, there are new treatments. In the area that needs correction, a magnet is implanted. The second is arranged in such a way that their interaction is aimed at correcting the defect. Some cosmetic problems are masked by implantation of silicone over the deformation site.