A different application of nuss procedure in a difficult case of pectus excavatum
Journal Title: International Journal of Orthopaedics Sciences - Year 2017, Vol 3, Issue 2
Abstract
A 17 year-old male patient who had a history of Nuss procedure 8 months ago with a diagnosis of pectus excavatum, the bar had been removed with left anterior thoracotomy due to complications such as bar dislocation, hemothorax and infection. Minimally invasive reoperation was performed on the patient who had an asymmetrical collapse distinctive on the right side. Classical Nuss operation was not possible due to strong adhesions that developed after past procedures. At this point, instead of open surgery, we entered the thoracic cavity with two new incisions performed on the two peak points of the collapse. A tunnel was formed beneath the sternum with obtuse and sharp opposing dissections through the newly formed holes. Subsequently, subcutaneous tunnels were opened up to the new entry holes through the initial incisions that were formed left and right previously. The bar was swiped under the sternum and rotated by using the subsequent holes as entry and exit holes for the bar. It was immobilized with a stabilizer. No complications occurred in the postoperative period. Pleural adhesions are accepted as one of the most important contraindications of thoracoscopic surgery. Nevertheless, with the help of two incisions in addition to the main procedure we present our case of re-operated pectus excavatum with a minimally invasive procedure and a successful outcome.
Authors and Affiliations
Halil Tözüm, Murat Demiroğlu, Kamil Kaynak
Keywords
Related Articles
- EP ID EP502515
- DOI 10.22271/ortho.2017.v3.i2g.65
- Views 138
- Downloads 0
Study of titanium elastic nailing system in long bone fractures in children at Pravara rural hospital, Loni
Globally, traumatic injuries of long bones shaft fractures in children are the most leading causes of fractures in children. Now a days the use of elastic stable intra-medullary nails has dramatically increased with the...
Pre-contoured locking plates vs. conventional reconstruction plates in AO type C distal humerus fractures: A prospective randomized study
Background: Reconstruction plates have been used from a long time for fixation of distal humerus fractures. Locking plates are increasingly used now-a-days. The aim of this study is to compare the radiological and functi...
A rare case of Fibrodysplasia ossificans progressive
Fibrodysplasia ossificans progressiva (FOP), a rare and disabling genetic condition characterized by congenital malformations of the great toes and progressive heterotopic endochondral ossification (HEO) which is the mos...
Management of chronic osteomylitis by wide debridement and closed suction: Drainage technique
Background: Chronic osteomyelitis remains one of the most challenging problems in orthopaedic surgery [1-6]. It commonly occurs after sequele of acute osteomylitis in children and teenagers, secondary osteomylitis due to...
Satisfaction of patients with amputated lower limb wearing external prostheses
Objective: To describe the level of satisfaction of patients with amputated lower limb wearing external prostheses in the town of Yaoundé. Methodology: A descriptive cross-sectional study was carried out at the National...