Introduction: Bar dislocation is one of the most dreaded complications following minimally invasive repair of pectus excavatum (PE). Practice patterns vary regarding bar securement, with some providers using unilateral or bilateral titanium stabilizers. Foreign bodies can be associated with increased morbidity including infection rate and complications during bar removal. We assess patients without the use of stabilizers compared to those with stabilizers. Methods: A retrospective analysis of patients treated for PE from November 2020 until June 2024 at a tertiary children's hospital. A comparison of those patients who used stabilizers to those without stabilizers was performed. Rates of bar displacement and bar-related complications were compared. Results: Ninety-seven total patients were analyzed with 63 receiving stabilizers and 34 with no stabilizers. There was no statistically significant difference in length of stay, readmission, complications, or bar displacements. Conclusion: Nuss bar placement without stabilizers can be a safe means of correcting PE without increased risk of bar displacement. Minimizing the amount of foreign material has the potential to mitigate postoperative infection, irritation, and pain from surgery. Level of Evidence: Level 2, retrospective study.
Keywords: Nuss; bar displacement; bar flipping; bar stabilizers; pectus.