Secondary Chest Wall Deformity

The surgical treatment of secondary chest wall deformity includes two main components: treatment of the primary disease and correction of the chest wall malformation.

Treatment of the primary disease: The diseases that can lead to secondary rib cage deformity are diverse. Therefore, it is crucial to conduct a detailed analysis of the primary disease and tailor the most appropriate surgical strategy before surgery. This is a fundamental principle in treating the primary disease.

Correction of thoracic wall deformities: Secondary chest wall deformity, similar to the primary one, manifests as abnormal appearance of the chest wall. Therefore, specific surgical procedures tailored to correct it, addressing either depression or protrusion, are required. However, when the localized lesion of the chest wall deformity is extremely severe, conventional reshaping surgery may not suffice. In such cases, chest wall reconstruction using materials like MatrixRIB, digital material, or autologous bone is necessary, thereby achieving a satisfactory appearance of the chest wall.

Surgical Treatment

Diagnosis involves assessing the patient’s clinical manifestations and physical signs, along with imaging examinations such as X-ray, contrast-enhanced chest CT scan, and 3D reconstruction imaging.

Diagnostic Methods

In addition to the abnormal appearance of the chest wall, secondary thoracic wall deformity may also manifest symptoms and signs of the primary diseases. For instance, deformity resulting from trauma might present with significant localized pain or even severe systemic symptoms. Similarly, chest wall indentation caused by chronic empyema may show pronounced symptoms of empyema. Overall, the clinical manifestations of secondary chest wall deformity can be more complex and severe compared to primary one.

Symptoms

The causes of secondary chest wall deformity can be categorized into three types: trauma, surgery, and disease.

Trauma: This is the most common cause of secondary chest wall deformity, typically involving severe chest injuries, such as multiple rib fractures and sternum fractures. These injuries can alter the shape of the chest, thus leading to malformations.

Surgery: Surgery is another important cause of secondary chest wall deformity. This includes general thoracic surgeries, cardiac surgeries, and various chest wall surgeries, such as surgeries for chest wall deformities, chest wall tumor, and chest wall infection. etc..

Disease: Certain diseases, such as pulmonary tuberculosis and chronic obstructive pulmonary disease, can lead to increased intrathoracic pressure, potentially disrupting the normal development of the chest and resulting in secondary chest wall deformity. Additionally, conditions like chronic empyema may also cause chest wall deformities, such as depression of the lateral chest wall.

Besides the previously mentioned causes, there are other factors that can lead to secondary rib cage deformity. One specific example is barrel chest, a condition that can develop due to prolonged hypoxia in high-altitude areas.

Causes

Secondary chest wall deformity refers to alterations in the bone structure of the chest wall due to a specific cause. This is distinct from primary chest wall deformity, which typically does not have an apparent cause.