Can Rib Flare Be Corrected? Pectus Excavatum Surgery Risks

Q: Can Rib Flare Be Corrected? Pectus Excavatum Surgery Risks

Hello： If there is a thoracic deformity, it is important to also pay attention to the possibility of associated spinal deformities and limb length discrepancies. <br>As for the correction of thoracic deformities, it falls under the scope of thoracic surgery, and the surgical risk

Left costal margin protrusion?

Hello Doctor,
For a long time, I have had a noticeable outward protrusion of my left rib cage, and I also have mild pectus excavatum.
I have consulted several orthopedic and thoracic surgeons, and they all recommended the Nuss procedure to correct my pectus excavatum.
They explained that rib flaring generally does not have a significant impact on health, but personally, I feel that the unilateral rib flaring continues to cause me an uneven burden while walking, sitting, and during various activities.
For example, when I walk, I tend to rely on my right foot, which has resulted in almost constant pain in my right foot.
I have researched the Nuss procedure, and it seems that there is no specific treatment for rib flaring associated with pectus excavatum.
Given that I am willing to undergo surgery, is rib flaring correctable? What are the potential risks and complications? This issue has troubled me for a long time, and I sincerely hope you can clarify my doubts.
Thank you very much!

Yang, 20~29 year old female. Ask Date: 2018/02/15

Dr. Wang Shouji reply Orthopedics

Hello: If there is a thoracic deformity, it is important to also pay attention to the possibility of associated spinal deformities and limb length discrepancies.
As for the correction of thoracic deformities, it falls under the scope of thoracic surgery, and the surgical risks and related issues should be discussed with a thoracic surgeon.

Reply Date: 2018/02/15

More Info

Rib flare, particularly when associated with conditions like pectus excavatum, can be a source of discomfort and functional limitations for many individuals. Pectus excavatum itself is a deformity of the chest wall where the sternum is sunken inward, which can lead to a variety of physical and psychological issues. The rib flare you describe, especially if it is unilateral, can indeed create an imbalance in your posture and gait, leading to compensatory patterns that may cause pain and discomfort in other areas, such as your right foot.

When considering surgical options, the Nuss procedure is often recommended for correcting pectus excavatum. This minimally invasive surgery involves placing a curved metal bar under the sternum to elevate it into a more normal position. While the primary focus of this surgery is to correct the sunken chest, it may also have a positive effect on rib flare, although this is not always guaranteed. The surgical correction of rib flare specifically may not be the primary goal of the Nuss procedure, and additional surgical interventions may be necessary to address this issue comprehensively.

Regarding the risks associated with the Nuss procedure and any potential corrections for rib flare, there are several factors to consider:
1. Surgical Risks: As with any surgery, there are inherent risks, including infection, bleeding, and complications related to anesthesia. Specific to the Nuss procedure, there is a risk of injury to the lungs, heart, or other structures in the chest cavity.

2. Postoperative Pain: Patients often experience significant pain after the surgery, which can last for several weeks. Pain management is a critical component of recovery.

3. Bar Displacement: The metal bar used in the Nuss procedure can shift or displace, requiring additional surgeries to correct.

4. Recurrence: There is a possibility that the pectus excavatum could recur after surgery, which may also affect rib positioning.

5. Long-term Considerations: Some patients may experience changes in their rib cage shape over time, which could lead to ongoing issues with rib flare or other deformities.

6. Physical Therapy: Post-surgery, physical therapy is often recommended to help restore function and address any muscular imbalances that may have developed due to the rib flare and pectus excavatum.

If you are considering surgery, it is crucial to have a thorough discussion with your surgeon about your specific concerns regarding rib flare. They can provide a tailored approach that may include additional procedures or therapies to address both the pectus excavatum and rib flare effectively.

In summary, rib flare can potentially be corrected, especially in the context of pectus excavatum surgery, but it is essential to understand the risks involved and the possibility that additional interventions may be necessary. Consulting with a specialized thoracic surgeon who has experience in treating both conditions will provide you with the best insight into your options and the expected outcomes.

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