Thoracic Deformity

Thoracic Deformity

A thoracic deformity is a malformation of the thorax or deformities of the chest wall. These malformations are either congenital or acquired. In the majority of cases, congenital forms of thoracic deformities are already evident in early infancy or early childhood. Other malformations of the thorax, on the other hand, only become apparent during puberty.

What is a thoracic deformity?

Basically, a thoracic deformity represents a shape of the chest wall or chest that deviates from the usual norm. Corresponding malformations can occur for genetic or acquired reasons. In the majority of cases, the chest deformity is a funnel chest. In most cases, this malformation manifests itself in a sunken breastbone and is the most common form of deformity. For what does kgb syndrome stand for, please visit ezhoushan.net.

If the thorax curves forward, it is referred to as a so-called keel chest. A special form is the Harrenstein deformity, in which the sternum is twisted. If the sternum attachments do not completely merge, a so-called sternum cleft develops. If the thorax does not close completely in the embryo, it is called thoracoschisis.

An asymmetrical appearance of the front chest wall may be due to a so-called forked rib. This sometimes shows connections to the Ehlers-Danlos syndrome or so-called chondrodysplasia, such as metaphyseal chondrodysplasia. In principle, thoracic deformities frequently occur in connection with various syndromes.

These include, for example, Ellis-van-Creveld syndrome, funnel chest or keel chest, asphyxiating thoracic dysplasia, Marfan syndrome, homocystinuria, Poland syndrome or spondyloepiphyseal dysplasia. In addition, thoracic deformities in connection with rickets or a rickety rosary as well as multiple pterygium syndrome and metaphyseal chondrodysplasia of the Jansen type are possible.

Causes

According to the current state of medical research, the causes of the formation of thoracic deformities have not yet been fully clarified. For example, disorders of the growth of the costal cartilages, which represent the connection between the bony ribs and the breastbone, are under discussion. In examinations with the electron microscope, a faulty structure of the cartilage matrix can sometimes be seen.

Inflammatory reactions were also found inside the cartilage. As a result, there is uninhibited growth of certain cartilage areas. These push the breastbone outwards or inwards. Existing connections to certain syndromes are also known, for example to Marfan syndrome.

The only thing that is certain so far is that the development of thoracic deformities is very complex. In many cases, genetic causes also play an important role in the formation of deformities. This is the case, for example, with growth disorders in costal cartilage. In addition to some of the syndromes already mentioned, which can occur in connection with thoracic deformities, corresponding malformations are also possible, for example due to tumors on the chest wall.

Symptoms, Ailments & Signs

In the context of thoracic deformities, numerous different symptoms and complaints are possible, which differ greatly depending on the syndrome and type of malformation. Basically, thoracic deformities often go hand in hand with so-called secondary pathologies. These include, for example, compression atelectasis, reduced cardiac output, respiratory insufficiency, restricted performance, scoliosis and other incorrect posture.

In addition, in many cases the deformities lead to considerable psychological stress for the patients, which may be accompanied by social distancing and isolation. In some cases, severe chest deformities are followed by chronic respiratory failure or atelectasis.

Diagnosis & course of disease

In principle, there are a number of examination methods available for diagnosing thoracic deformities, which the doctor treating you will decide on depending on the individual case. When a patient presents to the specialist for the first time, a thorough anamnesis or a discussion of the medical history takes place. For example, symptoms, the course of the disease and family dispositions are clarified.

This is followed by a so-called initial measurement, an ECG examination and a lung function test. Together with the clinical examinations, a differentiated picture of the present form of the thoracic deformity and the potential health impairments is now possible. This is because consequential damage is not to be expected in all patients.

However, there is no consensus in medical research as to whether thoracic deformities are generally associated with reduced lung function and performance as well as heart problems. In numerous cases, postural disorders appear in the context of thoracic deformities, especially in the case of a funnel chest or a quill chest.

The shoulders of the affected patient hang forward and there is a pronounced hollow back. In addition, there is often a so-called hunchback and a weak abdominal wall. In some cases, scoliosis appears on the spine at the same time. Basically, the aim of the clinical examinations is to identify all accompanying diseases in order to initiate suitable measures to treat the symptoms.

Complications

A common form of thoracic deformity is the so-called funnel chest. While there are usually no major physical limitations to be feared in children and adolescents, complications regularly occur with increasing age after the end of puberty. The malposition of the ribs can have a negative effect on the spine and lead to poor posture.

Kyphosis, which is accompanied by hunched shoulders and a protruding abdomen, is very common. The unnatural curvature of the spine also puts more strain on the intervertebral discs, which can cause severe back pain. In addition, due to the narrowing of the brood basket, other symptoms such as shortness of breath, tachycardia and rapid physical exhaustion are to be expected.

If an operation is necessary to correct the funnel chest or if this is done for cosmetic reasons, a number of complications can also arise. The procedure is minimally invasive, but is still carried out under general anesthesia, which is always associated with certain risks, in particular serious circulatory problems up to and including circulatory collapse.

The patient can also have an allergic reaction to the metal introduced for the purpose of correction. If premature removal is necessary for this reason, this can weaken or even negate the effect of the operation. Serious complications such as organ injuries, especially to the heart or lungs, are very rare, but cannot be completely ruled out.

When should you go to the doctor?

A congenital thoracic deformity is usually detected immediately after delivery. A birth is accompanied by midwives, doctors or nurses. Immediately after birth, the newborn is examined intensively by the obstetric team. During this initial examination, irregularities in the physique are already detected. The newborn is presented to the pediatrician for further examinations and clarification of the cause. Parents and relatives do not have to take action themselves in these cases. The necessary measures are completely taken over by the nursing staff present.

In the case of an acquired chest deformity, there is a triggering event. A fall, accident or violence can be the reason for the deformities. If there are changes in the physique and in particular in the chest, a doctor must be consulted.

If bulging of the chest wall or chest is noticed during the growth and development process of a child or adolescent, a doctor should be consulted. Impaired breathing, pain or restricted mobility are further signs of an irregularity. They need to be examined and treated.

A doctor should be consulted in the event of a restriction in physical performance, irregularities in the heart rhythm and changes in the complexion. Poor posture of the upper body, disorders of the muscular system and psychological problems should also be presented to a doctor for assessment. A diagnosis is necessary so that a treatment plan can be developed.

Treatment & Therapy

In the case of thoracic deformities, the therapeutic measures primarily depend on the type of disease present. Both conservative physiotherapeutic treatment approaches with targeted exercises and surgical operations are possible. In addition, the deformity should be checked by a doctor at regular intervals. A funnel chest can be treated with a suction cup to elevate the anterior chest wall.

Prevention

Concrete measures to prevent chest deformities are not yet known. Basically, it is important to ensure a healthy posture and sufficient exercise to prevent postural damage.

Aftercare

In the case of thoracic deformity, direct aftercare measures are severely limited in most cases, so that those affected by this disease are dependent on immediate medical treatment. The earlier the disease is recognized and treated, the better the further course is, as a rule. Self-healing is usually not possible, so a doctor should be consulted at the first sign of the disease.

Most patients with this disease are also dependent on various cosmetic procedures that can alleviate and limit the symptoms. These may have to be repeated more often, so that a complete limitation of the disease is not possible. Most of those affected also depend on the support of their own family or partner, which can also prevent depression or other mental upsets.

The chest deformity does not reduce the life expectancy of the person affected. Further aftercare measures are not necessary and usually not possible. Contact with other affected people to exchange experiences can be useful.

You can do that yourself

Patients with a chest deformity often suffer from various complaints resulting from the deformation of the chest. Therefore, the quality of life of those affected is partially restricted. If it is a congenital thoracic deformity, those affected learn to deal with the disease early on. The situation is often more difficult in those patients who acquired the disease later in life.

In some cases, the thoracic deformity is associated with reduced performance because the cardiac output is reduced. Self-help measures can support medical therapy for this type of complaint, but in no way replace it.

Patients attend regular check-ups with their doctor and take part in physiotherapy. Since poor posture can also result from the thoracic deformity, regular physiotherapeutic training is particularly important. Patients with thoracic deformities can continue the exercises they have learned at home.

Social problems and bullying can cause difficulties, since the patients deviate more or less from the norm due to the thoracic deformity and thus attract attention. Participation in self-help groups and socializing with other sufferers are ways to reduce these stressors . In this way, patients can expand their circle of acquaintances and thereby reduce social stress.

Thoracic Deformity