title: Distraction Osteogenesis of Multiple Ribs for the Treatment of Acquired Thoracic Dystrophy.
abstract: Acquired thoracic dystrophy is a complication associated with early open repair of pectus excavatum resulting from extensive cartilage resection. The condition can cause serious functional and physiologic impairments, including cardiac compression and restrictive pulmonary function. We describe a 17-year-old boy with acquired thoracic dystrophy after Ravitch repair of pectus excavatum during infancy, whom we treated with distraction osteogenesis. The patient had a marked deformity of the chest wall and general hypoplasia of the central portion of the ribcage, with resultant symptomatic dyspnea on exertion and reduced pulmonary function. After osteotomies and distraction osteogenesis of bilateral ribs 4-8 using customized distraction devices, he had improved thoracic contour, resolution of dyspnea, and decreased restrictive pulmonary symptoms. This case suggests that distraction osteogenesis, already used extensively in craniomaxillofacial and orthopedic surgery, may be a novel method for management of this condition.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, University of California, San Francisco, San Francisco, California.
authors.forename: Merisa L
authors.initials: ML
authors.lastname: Piper
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, University of California, San Francisco, San Francisco, California.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Delrosario
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, University of California, San Francisco, San Francisco, California william.hoffman@ucsf.edu.
authors.forename: William Y
authors.initials: WY
authors.lastname: Hoffman
mesh_terms: D002648:Child; D005541:Forced Expiratory Volume; D005660:Funnel Chest / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D019857:Osteogenesis, Distraction / Q000379:methods*; D010027:Osteotomy / Q000379:methods; D012272:Ribs / Q000000981:diagnostic imaging / Q000601:surgery*; D013249:Sternum / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D035441:Thoracic Wall / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014109:Total Lung Capacity; D016896:Treatment Outcome; D014797:Vital Capacity