26.01.2021

Chest deformity in children

Chest deformity in children is a serious congenital or acquired pathology. It occurs in 2% of babies. Depending on the degree of the disease, the child may develop functional disorders of the heart and respiratory system.

Causes of deformation

The most common cause of abnormal chest formation is genetics. That is, while still in the womb, the fetus receives a program responsible for the improper development and growth of the cartilage of the chest. Fortunately, in many cases, the child’s congenital chest deformity can be corrected if the child is treated in time.

Acquired chest deformity in a child occurs due to serious diseases such as rickets, bone tuberculosis, chronic respiratory pathologies, scoliosis, as well as injuries and burns that occur in the sternum.

How is the pathology manifested?

In 92% of children with congenital chest pathology, a funnel-shaped sternum deformity is detected. It is characterized by an inferior growth of costal cartilage and a significant increase in the sternum in the transverse axis. As the child grows, the pathology becomes more pronounced, while the chest cavity decreases, which in the future becomes the cause of curvature of the spine and impaired functioning of the heart, blood vessels, and respiratory organs.

Children with chest deformity, in comparison with healthy peers, are lagging behind in physical development, are more often ill with colds and broncho-pulmonary diseases, vegetative pathologies, they get tired more quickly during sports.

Types of pathology

Chest deformity is classified into the following types:

  1. Keeled : Chest protrudes forward, as if a keel from a boat. In common people is called “chicken breast”.
  2. Funnel-shaped : the rib cage looks too hollow, as if pressed inward. The second name is “the shoemaker’s chest”.
  3. Flat : the sternum and ribs are flattened to the anteroposterior axis.
  4. Congenital cleft of the chest : the sternum as if split into two parts.
  5. Curved : Currarino-Silverman syndrome, is rare.
  6. Musculoskeletal anomaly : this is a complex pathology of bone tissue, affecting not only the chest, but also the spine, muscle system and other organs.

The degree of severity of the deformation is different: in some children, a slight cosmetic defect that does not require serious correction can be noted, and in others, a pronounced pathology.

In modern traumatology, 3 degrees of chest deformation are distinguished:

  • 1 degree.  The depth of the funnel-shaped recess is not more than 2 cm. No displacement of the heart is detected.
  • 2 degree.  The depth of the funnel is from 2 to 4 cm. The heart is displaced to 3 cm.
  • 3 degree.  The depth of the funnel is from 4 cm. The displacement of the heart is more than 3 cm.

The 2nd and 3rd degree of deformation of the chest in a child is characterized by pathological pressure of the sternum on the lungs. This is fraught with the development of chronic bronchopulmonary diseases – bronchitis, pneumonia, etc.

Diagnostic Methods

A physical examination by a children’s doctor makes it possible to identify changes in the shape, symmetry and circumference of the chest in children, wheezing in the lungs, heart murmurs, etc. Often, when examining such children, dysembryogenetic stigma is diagnosed: increased joint mobility, Gothic palate, etc. deformed structure of the chest require mandatory consultation with a thoracic surgeon, orthopedist and traumatologist.

Thoracometry diagnoses the degree and type of deformity, estimates the depth and width of the chest, refines thoracic parameters and tracks them in dynamics. Computed tomography and chest x-ray of children can provide more accurate data on existing changes in the sternum, ribs and spine. With their help, the bone structure of the chest, the presence of pathological changes in the lungs, the displacement of organs in relation to each other are evaluated.

Treatment

Treatment of chest deformity in a child is carried out under the strict supervision of an orthopedist. The keel-shaped pathology of the sternum does not require specific therapy, since it does not interfere with the full functioning of the internal organs. In this case, children may experience only slight fatigue and shortness of breath. The defect is easy to repair with thoracoplasty.

Conservative therapy is carried out with a hollow chest. The course of treatment depends entirely on the degree of retraction of the sternum. Grades 1 and 2 require medical gymnastics, with emphasis on the sternum: the patient learns to do push-ups, stretch dumbbells to the sides, and pull himself up. Also, the child is shown to engage in sports such as rowing and volleyball – the loads obtained as a result of these exercises prevent further sternal retraction. The result gives a quality massage.

In severe cases, a surgical operation is prescribed, but it can be performed no earlier than the child’s 7th birthday. The fact is that at this age, the pathology ceases to form. During the operation, the doctor makes an incision in the chest of the child and inserts a magnetic plate there. After surgery, a special belt with a magnet is put on the chest outside. They begin to attract each other, a gradual healing effect occurs – usually the sunken chest changes after 2 years of wearing magnetic plates.

If a chest defect is caused by heredity, then the child is initially examined for possible pathologies that could cause this deformation, and then treatment is carried out – conservative or surgical, depending on the underlying cause of the disease.

Prevention

Preventive measures include the following recommendations:

  1. Regular medical examinations.
  2. Timely treatment of diseases of the respiratory system.
  3. Avoidance of injuries and burns to the chest.
  4. Exercise, sufficient physical activity of the child with training the muscles of the abdominals, spine, back.
  5. Healthy eating

The sooner a child’s chest deformity is diagnosed, the more successful and easier the treatment will be. In addition, at the initial stage of the disease, pathology can be cured without resorting to surgical treatment.

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