title: Refinements in pectus carinatum correction: the pectoralis muscle split technique.
abstract: BACKGROUND
  The standard approach for correction of pectus carinatum deformity includes elevation of the pectoralis major and rectus abdominis muscle from the sternum and adjacent ribs. A postoperative restriction of shoulder activity for several weeks is necessary to allow stable healing of the elevated muscles. To reduce postoperative immobilization, we present a modified approach to the parasternal ribs using a pectoralis muscle split technique.
  
  
  METHODS
  At each level of rib cartilage resection, the pectoralis muscle is split along the direction of its fibers instead of elevating the entire muscle as performed with the standard technique. From July 2000 to May 2007, we successfully used this technique in 33 patients with pectus carinatum deformity.
  
  
  RESULTS
  After the muscle split approach, patients returned to full unrestricted shoulder activity as early as 3 weeks postoperatively, compared to 6 weeks in patients treated with muscle flap elevation. Postoperative pain was reduced and the patients were discharged earlier from the hospital than following the conventional approach.
  
  
  CONCLUSIONS
  The muscle split technique is a modified surgical approach to the parasternal ribs in patients with pectus carinatum deformity. It helps to maintain pectoralis muscle vascularization and function and can reduce postoperative pain, hospitalization, and rehabilitation period.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria. anton.schwabegger@i-med.ac.at
authors.forename: Anton H
authors.initials: AH
authors.lastname: Schwabegger
authors.forename: Johannes
authors.initials: J
authors.lastname: Jeschke
authors.forename: Tanja
authors.initials: T
authors.lastname: Schuetz
authors.forename: Barbara
authors.initials: B
authors.lastname: Del Frari
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D009139:Musculoskeletal Abnormalities / Q000601:surgery*; D010027:Osteotomy; D010369:Pectoralis Muscles / Q000601:surgery*; D012272:Ribs / Q000002:abnormalities* / Q000601:surgery; D013249:Sternum / Q000002:abnormalities* / Q000601:surgery; D019616:Thoracic Surgical Procedures