On the surgical treatment of pectus excavatum

80 cases of funnel chest were treated surgically, 9 by Gross procedure, 41 by turn-over technique and 30 by reverse "V" shape osteotomy of the sternum and ribs with internal fixation. There were 56 boys and 24 girls, with ages ranging from 2 to 14 years. The sternal depression varied in depth from 3 to 4 cm, and in volume from 20 to 120 ml. Roentgenographically, there were different extents of deviation of the heart to the left. Some patients had abnormal ECG. To study the results of operations, 48 cases were followed-up for 0.5 to 19 years. We found that the results of reverse "V" shape osteotomy of the sternum and ribs with internal fixation were superior to others. Its main advantage lies in the internal fixation which holds the sternum stable thus favoring wound healing and permanent correction. It is simple with less surgical trauma and postoperative complications. Some disappointing results in the other two techniques, such as uneven chest wall, flat chest and forward protruding of the sternum could also be avoided by this procedure. The internal fixation device was removed one year after operation. Follow-up for 3 to 4 years found the chest wall in satisfactory contour.