The bridge technique for pectus bar fixation: a method to make the bar un-rotatable

J Pediatr Surg. 2015 Aug;50(8):1320-2. doi: 10.1016/j.jpedsurg.2014.12.001. Epub 2014 Dec 5.

Abstract

Purpose: Pectus bar rotation is a major challenge in pectus repair. However, to date, no satisfactory technique to completely eliminate bar displacement has been introduced. Here, we propose a bar fixation technique using a bridge that makes the bar unmovable. The purpose of this study was to determine the efficacy of this bridge technique.

Methods: A total of 80 patients underwent pectus bar repair of pectus excavatum with the bridge technique from July 2013 to July 2014. The technique involved connecting 2 parallel bars using plate-screws at the ends of the bars. To determine bar position change, the angles between the sternum and pectus bars were measured on postoperative day 5 (POD5) and 4 months (POM4) and compared.

Results: The mean patient age was 17.5 years (range, 6-38 years). The mean difference between POD5 and POM4 were 0.23° (P=.602) and 0.35° (P=.338) for the upper and lower bars, respectively. Bar position was virtually unchanged during the follow-up, and there was no bar dislocation or reoperation.

Conclusions: A "bridge technique" designed to connect 2 parallel bars using plates and screws was demonstrated as a method to avoid pectus bar displacement. This approach was easy to implement without using sutures or invasive devices.

Keywords: Chest wall; Minimally invasive surgery; Pectus bar stabilization; Pectus excavatum.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Bone Plates
  • Bone Screws
  • Child
  • Female
  • Follow-Up Studies
  • Funnel Chest / surgery*
  • Humans
  • Male
  • Orthopedic Procedures / instrumentation
  • Orthopedic Procedures / methods*
  • Sternum / surgery
  • Treatment Outcome
  • Young Adult