title: The bridge technique for pectus bar fixation: a method to make the bar un-rotatable.
abstract: OBJECTIVE
  Pectus bar rotation is a major challenge in pectus repair. However, to date, no satisfactory technique to completely eliminate bar displacement has been introduced. Here, we propose a bar fixation technique using a bridge that makes the bar unmovable. The purpose of this study was to determine the efficacy of this bridge technique.
  
  
  METHODS
  A total of 80 patients underwent pectus bar repair of pectus excavatum with the bridge technique from July 2013 to July 2014. The technique involved connecting 2 parallel bars using plate-screws at the ends of the bars. To determine bar position change, the angles between the sternum and pectus bars were measured on postoperative day 5 (POD5) and 4 months (POM4) and compared.
  
  
  RESULTS
  The mean patient age was 17.5 years (range, 6-38 years). The mean difference between POD5 and POM4 were 0.23° (P=.602) and 0.35° (P=.338) for the upper and lower bars, respectively. Bar position was virtually unchanged during the follow-up, and there was no bar dislocation or reoperation.
  
  
  CONCLUSIONS
  A "bridge technique" designed to connect 2 parallel bars using plates and screws was demonstrated as a method to avoid pectus bar displacement. This approach was easy to implement without using sutures or invasive devices.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-Daero, Seocho-Gu, Seoul 137-701, Korea. Electronic address: hyjpark@catholic.ac.kr.
authors.forename: Hyung Joo
authors.initials: HJ
authors.lastname: Park
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-Daero, Seocho-Gu, Seoul 137-701, Korea.
authors.forename: Kyung Soo
authors.initials: KS
authors.lastname: Kim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-Daero, Seocho-Gu, Seoul 137-701, Korea.
authors.forename: Young Kyu
authors.initials: YK
authors.lastname: Moon
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, College of Medicine, Yonsei University, 211 Eunjoo-Ro, Gangnam -Gu, Seoul 135-720, Korea.
authors.forename: Sungsoo
authors.initials: S
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D001860:Bone Plates; D001863:Bone Screws; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005660:Funnel Chest / Q000601:surgery*; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures / Q000295:instrumentation / Q000379:methods*; D013249:Sternum / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult
keywords: Chest wall; Minimally invasive surgery; Pectus bar stabilization; Pectus excavatum