Congenital deformities of the chest wall are a very common pathology in our population and increasingly valued in recent years. Technological and digital evolution has allowed young people to research and learn more about this pathology, contributing to a greater understanding of the deformity and its treatment.
These deformities are generally divided into five categories: Pectus Excavatum, or excavated chest, Pectus Carinatum, or keel chest, Poland syndrome, sternal defects, and thoracic deformities associated with systemic skeletal diseases.
In the group of deformities, the most frequent are Pectus Excavatum, with an incidence in the general population of 1:500, being four times more frequent in males, followed by Pectus Carinatum, with an incidence four times lower. In addition, there are also mixed changes combining characteristics of both deformities mentioned, which can be asymmetric (more pronounced in one half of the thorax than in the other), or unilateral (only on one side).
They usually appear in the anterior part of the thorax, where the ossified structure extends through the cartilage that connects to the sternum. The arrangement and distribution of collagen in the costal cartilage are altered and undergo an abnormal development in the face of tension, compression and flexion mechanisms, and it is this deep growth that causes a depression of the anterior wall (including the sternum) or projection of the wall, Pectus Excavatum and Pectus Carinatum, respectively.
In the first years of life, it is possible that the deformities begin to manifest themselves, however, in the vast majority of cases they are detected during adolescence due to faster growth.
Sometimes these bone deformities of the thoracic wall are associated with mammary hypoplasia (incomplete development of a breast) on the same side as the deformation, and partial absence of some ribs.
This group of deformities covers all types of thoracic wall deformities except those of the thoracic spine, the latter are usually associated with other alterations of the spine, such as scoliosis and lordosis, treated by Orthopedics.