Long-term changes in bone and cartilage after Ravitch's thoracoplasty: findings from multislice computed tomography with 3-dimensional reconstruction.
OBJECTIVE
The aim of the study was to evaluate the long-term changes in the bones, cartilage, and chest wall contour after a Ravitch's thoracoplasty (RTP) using multislice computed tomography with 3-dimensional reconstruction (3D-MSCT).


METHODS
Between 1985 and 2000, 114 patients with pectus excavatum (PE) underwent RTP in our hospital; 3D-MSCT was performed in 36 patients 4 to 18 years after the initial operation. Twenty-four patients with PE with no surgical intervention were enrolled as a control group.


RESULTS
Partial or complete calcification of the regenerated cartilage was found in 23 (64%) of the patients. Threadlike regenerated cartilage or the complete absence of some segment was seen in 14 cases (39%). Clubbing of the bony end was found in 23 cases (64%). Shortening of the gap between the rib end and the sternum (n = 17, 47%) and "constrict-in" of the ribs (n = 13, 36%) were common after RTP. In the control group, no significant bone or cartilage change occurred compared to the RTP group.


CONCLUSIONS
Modern 3D-MSCT technology can clearly depict the cartilage and bone in patients with PE. More than 60% of the patients with PE showed significant long-term changes in the bone and cartilage after RTP. Further studies are warranted to evaluate the impact of these abnormal findings.
Chang
Pei-Yeh
PY
Department of Pediatric Surgery, Chang Gung Children's Hospital, Chang Gung University, School of Medicine, Taoyuan 333, Taiwan.
Lai
Jin-Yao
JY
Chen
Jeng-Chang
JC
Wang
Chao-Jan
CJ
D000293:Adolescent; D000328:Adult; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D002356:Cartilage / Q000000981:diagnostic imaging*; D002648:Child; D005260:Female; D005660:Funnel Chest / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D009140:Musculoskeletal Diseases / Q000209:etiology; D019616:Thoracic Surgical Procedures / Q000009:adverse effects*; D035441:Thoracic Wall / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed