Costochondral changes in the chest wall after the Nuss procedure: ultrasonographic findings

Qi Zeng, Jin Yao Lai, Xiao Man Wang, Jhon Liau Lee, Shu Ti Chia, Chao Jan Wang, Jeng Chang Chen, Pei Yeh Chang

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)


Purpose: The Nuss procedure is one of the most popular surgeries for correcting pectus excavatum. However, little is known regarding stress and strain on the deformed ribs after inserting the pectus bar. We used ultrasonography to investigate costochondral changes before and after the Nuss procedure. Methods: Ninety-five patients underwent the Nuss procedure between July 2007 and February 2008 at 2 institutions. Chest ultrasonography, specifically of the bones and cartilage, was performed 1 day before and 1 week after the operation. Results: Postoperatively, all patients showed various degrees of deformation from the second to sixth cartilages bilaterally. The cartilages were not fractured. Of these patients, 28 (29.5%) had significant changes, including acute angulation of the costochondral junction and rib fractures near the pectus bar. These changes were associated with increased age (P < .01) and the degree of postoperative sternum elevation (P < .01). The pectus index and sex were not significant predictors of rib damage. Conclusions: The Nuss procedure created significant stress and strain over the deformed cartilages. Approximately 29% of the patients showed localized, self-limited costochondral changes via chest ultrasonography.

Original languageEnglish
Pages (from-to)2147-2150
Number of pages4
JournalJournal of pediatric surgery
Issue number12
Publication statusPublished - 2008 Dec 1

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Fingerprint Dive into the research topics of 'Costochondral changes in the chest wall after the Nuss procedure: ultrasonographic findings'. Together they form a unique fingerprint.

Cite this