title: A survey of musculoskeletal and aesthetic abnormalities after thoracotomy in pediatric patients.
abstract: OBJECTIVE
  To study the incidence and type of musculoskeletal and aesthetic abnormalities after thoracotomy in children.
  
  
  METHODS
  Children below 12 years of age who had undergone thoracotomy for any condition and have at least 2 years follow up were included in the study. Detailed assessment of the patients included: history and general examination, clinical examination of chest and musculoskeletal system, X-ray chest including bilateral shoulders [antero-posterior (AP), lateral, oblique], X-ray whole spine (AP, lateral, right and left side bending AP view).
  
  
  RESULTS
  Fifty-two pateints were recruited. The incidences of various clinically and radiologically assessed musculoskeletal and aesthetic abnormalities observed were: winging of scapula (5.7%), ipsilateral elevation of shoulder (5.7%), fixation of skin cicatrix to bony thorax (7.7%), maldevelopment of pectoral muscles (11.5%), asymmetry of the level of nipples (1.9%), rib fusion (5.7%), crowding of ribs (9.6%), mediastinal shift (3.8%), decreased space available for lungs (3.8%), Scoliosis with Cobb's angle >10(0) (1.9%).
  
  
  CONCLUSIONS
  The incidences of musculoskeletal and aesthetic abnormalities after posterolateral thoracotomies in children were low. Longer follow up of patients after thoracotomy is needed to pick up these abnormalities as the children grow.
authors.affiliation: Department of Pediatric Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
authors.forename: Shasanka Shekhar
authors.initials: SS
authors.lastname: Panda
authors.affiliation: Department of Pediatric Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Agarwala
authors.affiliation: Department of Pediatric Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
authors.forename: Veereshwar
authors.initials: V
authors.lastname: Bhatnagar
authors.affiliation: Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
authors.forename: Sushil Kumar
authors.initials: SK
authors.lastname: Kabra
authors.affiliation: Department of Orthopedics, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
authors.forename: Arvind
authors.initials: A
authors.lastname: Jayaswal
authors.affiliation: Department of Radiodiagnosis, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
authors.forename: Ashu Seith
authors.initials: AS
authors.lastname: Bhalla
keywords: Aesthetic abnormalities; long term follow-up; musculoskeletal abnormalities; thoracotomy in children