title: Lateral thoracic expansion for Jeune syndrome: evidence of rib healing and new bone formation.
abstract: BACKGROUND
  Lateral thoracic expansion is a procedure that has been described to enlarge the thoracic cage in patients with Jeune's asphyxiating thoracic dystrophy. The procedure involves separating ribs from their periosteum and plating them together in an expanded fashion with titanium struts. We have speculated that the ribs heal in this situation, despite the absence of surrounding periosteum, and that new rib formation occurs in the liberated periosteum.
  
  
  METHODS
  Radiographic studies of patients who have undergone lateral thoracic expansion were reviewed for evidence of rib healing or periosteal new bone formation.
  
  
  RESULTS
  This study presents radiologic evidence that rib healing actually occurs, as does periosteal ossification.
  
  
  CONCLUSIONS
  Lateral thoracic expansion creates additional chest wall that is formed of autologous tissue, fully healed, and not ultimately dependent on titanium struts.
authors.affiliation: Department of Cardiothoracic Surgery, Children's Hospital, Columbus, Ohio, USA. tdavis@chi.osu.edu
authors.forename: J Terrance
authors.initials: JT
authors.lastname: Davis
authors.forename: Frederick R
authors.initials: FR
authors.lastname: Long
authors.forename: Brent H
authors.initials: BH
authors.lastname: Adler
authors.forename: Robert G
authors.initials: RG
authors.lastname: Castile
authors.forename: Samuel
authors.initials: S
authors.lastname: Weinstein
mesh_terms: D001238:Asphyxia Neonatorum / Q000000981:diagnostic imaging / Q000601:surgery*; D001860:Bone Plates; D001861:Bone Regeneration / Q000502:physiology*; D016723:Bone Remodeling / Q000502:physiology; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010009:Osteochondrodysplasias / Q000000981:diagnostic imaging / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D010521:Periosteum / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D012272:Ribs / Q000000981:diagnostic imaging / Q000601:surgery*; D013577:Syndrome; D035441:Thoracic Wall / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed