Chest wall defect refers to the absence of chest wall structure, including skin, soft tissue, and bone structure. Defect of the bone structure is commonly seen in the ribs and costal cartilages, while sternum defect is less common and is usually confined to specific areas.

The cause of primary chest wall defect remains unclear, but it is believed to involve congenital underdevelopment or genetic factor. Additionally, certain congenital diseases may contribute to the defect. For example, patients with conditions like Poland syndrome or thoracic dysplasia syndrome may exhibit missing ribs.

The causes of secondary chest wall defect are well-defined and are often seen after chest wall trauma, surgery, or infection. Other factors, such as necrotic skin ulcer resulting from radiation therapy after breast cancer surgery, can also lead to the defect.

The symptoms of chest wall defect differ based on the type, severity, and individual differences. Common symptoms include chest pain, breathing difficulty, and coughing with bloody sputum. Additionally, chest wall defect may leads to chest wall infection, which manifests as localized swelling, pain, and fever.

Diagnosis involves assessing the patient’s clinical manifestations and physical signs, along with imaging examinations such as X-ray, chest CT scan，etc.

It is important to note that, due to the complex causes of chest wall defect, careful examination of the patient’s medical history during diagnosis is essential. Additionally, examination items should be determined based on the specific condition of the patient.

The surgical approach for chest wall defect depends on the type and size of the defect, as well as the patient’s individual circumstance. Here are some common surgical procedures:

1. Chest wall reconstruction: This is the most common surgery for repairing chest wall defect. It involves using artificial material (such as MatrixRIB or autologous material to reconstruct the bone structure of the defect, restoring the integrity and stability of the chest wall.

2. Rib implantation: For rib defect, rib implantation surgery can be performed by transplanting rib segments from other parts of the patient’s body (such as the sternum or back) to the defect area. The transplanted rib segments are then fixed in the defect area to reconstruct the missing rib structure.

3. Flap Repair: For soft tissue defect in the chest wall, flap repair can be performed, such as through pedicled flap and free flap plasty to cover and repair the soft tissue defect.