[Plastic surgery of the thoracic wall (malformations and tumors) using a sliding splint-stapler]

Abstract

Chest wall instability, created surgically by correction of a chest deformity (funnel chest or, more rarely, pigeon chest) or by resection of a tumour of the chest wall, is serious as it can jeopardize the immediate vital prognosis because of paradoxical respiration and, in the long term, the functional and aesthetic prognosis due to progressive impaction of the unstable segment of the wall. The polyvalent and adaptable material which we have developed (sliding splint-staple) and which we also use in thoracic traumatology (thoracic flaps), has allowed us to perform audacious corrections for deformities or wide resections for tumours since 1980. We have used this material on 13 occasions for contention after sternochrondroplasty, with an excellent result in each case both in terms of the immediate stability and in terms of the aesthetic result. The sliding splint-staples, generally two, are placed in staggered positions behind the sternum (11 cases--funnel chest) or in front of the sternum (2 cases--pigeon chest). The material is left in place for at least one year. We have used this material on 8 occasions after various tumour resections: 3 times after subtotal resection of the sternochrondral breastplate and 5 times after lateral or anterolateral resection removing at least 2 ribs.