title: Analysis of changes to the anterior chest wall after the Nuss procedure-an objective measurement of pectus excavatum.
abstract: BACKGROUND
  We report a noninvasive method for recording the deviation of the anterior chest wall (ACW) in patients with pectus excavatum before and after the insertion and removal of a Nuss bar.
  
  
  METHODS
  All patients undergoing the Nuss procedure at our institutions between June 2008 and February 2009 were enrolled in this study. A thermal plastic strip was used to cast the ACW at the skin level along the area corresponding to the tract of the inserted bar. The height of the ACW was defined as the perpendicular length from the xiphoid process to the transverse line drawn between the 2 midaxillary points.
  
  
  RESULTS
  Bar insertion caused a significant increase in ACW height and width. Bar removal reduced the corrective effects in terms of a significant decrease in ACW height; at the same time, an increase in ACW width was noted.
  
  
  CONCLUSIONS
  Feature extraction and analyses of permanent contour casts of the ACW help to understand immediate changes in the ACW after the Nuss procedure and may assist in the design of the bar at insertion. The Nuss bar in situ helped to maintain cosmetic benefits to the ACW.
authors.affiliation: Department of Surgery, Chang Gung Memorial Hospital, Chang-Gung University, Taoyuan, Taiwan.
authors.forename: Pei-Yeh
authors.initials: PY
authors.lastname: Chang
authors.forename: Chaur-Hsiang
authors.initials: CH
authors.lastname: Chang
authors.forename: Jin-Yao
authors.initials: JY
authors.lastname: Lai
authors.forename: Jeng-Chang
authors.initials: JC
authors.lastname: Chen
authors.forename: Der-Baau
authors.initials: DB
authors.lastname: Perng
authors.forename: Qi
authors.initials: Q
authors.lastname: Zeng
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D001837:Body Weights and Measures / Q000379:methods; D001915:Braces / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D020878:Device Removal / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D005660:Funnel Chest / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011184:Postoperative Period; D035441:Thoracic Wall / Q000033:anatomy & histology* / Q000601:surgery; D016896:Treatment Outcome