title: Indications for surgical repair of funnel chest based on indices of chest wall deformity and psychological state.
abstract: OBJECTIVE
  We examined the surgical indications for funnel chest, taking psychological factors into consideration.
  
  
  METHODS
  We assessed 36 young people with funnel chest who were seen as outpatients, including 31 boys and 5 girls aged from 1 to 22 years old. Respondents were asked whether they suffered psychological distress, and if they wanted surgery. The severity of the deformity was evaluated using the Vertebral Index (VI) and the Frontosagittal Index (FSI) calculated from chest roentgenograms.
  
  
  RESULTS
  The VI in 11 patients without distress (23.7 +/- 4.1) was lower than that in 25 patients with distress (32.8 +/- 8.2), and the FSI in the patients without distress (33.5 +/- 5.3) was higher than that in the patients with distress (23.6 +/- 8.6). The VI in 19 patients who did not want surgery (26.9 +/- 7.9) was lower than that in 17 patients who did (33.5 +/- 7.5), and the FSI in the patients who did not want surgery (30.4 +/- 8.1) was higher than that in the patients who did (22.4 +/- 8.1). The distressed patients suffered many psychological problems, such as being the object of bullying.
  
  
  CONCLUSIONS
  The severity of the deformity affected the patient's psychological state. We consider that a VI >28 or an FSI <28 are indications for surgery, based on the mean VI + SD and the mean FSI-SD of patients not suffering distress.
authors.affiliation: Second Department of Surgery, Osaka City University Medical School, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Ohno
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Morotomi
authors.forename: Masashi
authors.initials: M
authors.lastname: Nakahira
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takeuchi
authors.forename: Chizuka
authors.initials: C
authors.lastname: Shiokawa
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Moriuchi
authors.forename: Ken
authors.initials: K
authors.lastname: Harumoto
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Nakaoka
authors.forename: Masanao
authors.initials: M
authors.lastname: Ueda
authors.forename: Tatsuyuki
authors.initials: T
authors.lastname: Yoshida
authors.forename: Hiroto
authors.initials: H
authors.lastname: Yamada
authors.forename: Kasuke
authors.initials: K
authors.lastname: Tsujimoto
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kinoshita
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003657:Decision Making; D005260:Female; D005660:Funnel Chest / Q000523:psychology* / Q000601:surgery*; D006801:Humans; D007223:Infant; D007398:Interpersonal Relations; D008297:Male; D019637:Orthopedic Procedures; D010347:Patient Care Planning; D011788:Quality of Life; D012720:Severity of Illness Index; D013315:Stress, Psychological