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J Pediatr Surg. 2015 Aug;50(8):1320-2. doi: 10.1016/j.jpedsurg.2014.12.001. Epub 2014 Dec 5.

The bridge technique for pectus bar fixation: a method to make the bar un-rotatable.

Author information

1
Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-Daero, Seocho-Gu, Seoul 137-701, Korea. Electronic address: hyjpark@catholic.ac.kr.
2
Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-Daero, Seocho-Gu, Seoul 137-701, Korea.
3
Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, College of Medicine, Yonsei University, 211 Eunjoo-Ro, Gangnam -Gu, Seoul 135-720, Korea.

Abstract

PURPOSE:

Pectus bar rotation is a major challenge in pectus repair. However, to date, no satisfactory technique to completely eliminate bar displacement has been introduced. Here, we propose a bar fixation technique using a bridge that makes the bar unmovable. The purpose of this study was to determine the efficacy of this bridge technique.

METHODS:

A total of 80 patients underwent pectus bar repair of pectus excavatum with the bridge technique from July 2013 to July 2014. The technique involved connecting 2 parallel bars using plate-screws at the ends of the bars. To determine bar position change, the angles between the sternum and pectus bars were measured on postoperative day 5 (POD5) and 4 months (POM4) and compared.

RESULTS:

The mean patient age was 17.5 years (range, 6-38 years). The mean difference between POD5 and POM4 were 0.23° (P=.602) and 0.35° (P=.338) for the upper and lower bars, respectively. Bar position was virtually unchanged during the follow-up, and there was no bar dislocation or reoperation.

CONCLUSIONS:

A "bridge technique" designed to connect 2 parallel bars using plates and screws was demonstrated as a method to avoid pectus bar displacement. This approach was easy to implement without using sutures or invasive devices.

KEYWORDS:

Chest wall; Minimally invasive surgery; Pectus bar stabilization; Pectus excavatum

PMID:
25783318
DOI:
10.1016/j.jpedsurg.2014.12.001
[Indexed for MEDLINE]

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