Deformation of a thorax – the congenital or acquired change of a shape of a thorax. The term "thorax" is meant as the bone and muscular framework of the top part of a trunk protecting internals. Deformation of a thorax can have the displastichesky and acquired character. Distinguish keeled, funneled and flat congenital deformation of a thorax. The acquired deformations subdivide on emphysematous, boatshaped, paralytic and kifoskoliotichesky. Deformation of a thorax inevitably influences the heart, easy and other bodies located in a chest cavity, causing violation of their normal activity.
Deformation of a thorax
Deformation of a thorax – the congenital or acquired change of a shape of a thorax. The term "thorax" is meant as the bone and muscular framework of the top part of a trunk protecting internals. Deformation of a thorax inevitably influences the heart, easy and other bodies located in a chest cavity, causing violation of their normal activity.
All deformations of a thorax are divided into two groups: displastichesky (congenital) and acquired. Congenital deformations meet less than acquired. The acquired deformations develop owing to various diseases (chronic diseases of lungs, bone tuberculosis, rickets and scoliosis), injuries and burns of area of a thorax.
Congenital deformations are caused by an underdevelopment or anomalies of development of a backbone, edges, breasts, shovels and muscles of a thorax. The heaviest deformations arise at violation of development of bone structures.
Depending on localization allocate violation of a form of a lobby, back and sidewalls of a thorax. Expressiveness of deformation can be various: from almost imperceptible cosmetic defect to the rough pathology causing violation of work of heart and lungs.
At congenital deformations the form of a forward surface of a thorax, as a rule, changes. Violation of a form is followed by an underdevelopment of a breast and muscles, absence or an underdevelopment of edges.
Funneled deformation of a thorax
The violation of a shape of a breast caused by a zapadeniye of a breast, forward departments of edges and costal cartilages. A funneled thorax - the most widespread malformation of a breast. It is supposed that funneled deformation arises because of genetically caused change of normal structure of cartilages and connecting fabric. At children with a funneled breast multiple malformations are often observed, and in the family anamnesis cases of similar pathology at close relatives come to light.
Leads Zapadeny breasts at this malformation to reduction of volume of a chest cavity. Sharply expressed violation of a shape of a breast causes a backbone curvature, heart shift, violation of work of heart and lungs, change of arterial and venous pressure.
In traumatology allocate three extents of funneled deformation:
- I degree. Depth of a funnel is less than 2 cm. Heart is not displaced.
- II degree. Depth of a funnel is 2-4 cm. Shift of heart is up to 3 cm.
- III degree. Depth of a funnel is 4 cm and more. Heart is displaced more than on 3 cm.
At newborns and children of younger age deformation is a little noticeable. Zapadeniye of edges and a breast amplifies during a breath (a breath paradox). In process of growth of the child pathology becomes more expressed and by 3 years reaches a maximum. Children with this congenital pathology lag behind in physical development, suffer from vegetative frustration and frequent catarrhal diseases.
In the subsequent deformation becomes fixed. Funnel depth gradually increases, reaching 7-8 cm. At the child scoliosis and chest develops. Reduction of respiratory excursions of a thorax by 3-4 times in comparison with age norm comes to light. Violations from cardiovascular and respiratory system accrue.
For the purpose of diagnostics of changes of heart and the lungs caused by deformation of a thorax, to the patient conduct the whole complex of examinations: X-ray analysis of lungs, echocardiography, ECG, etc.
Conservative therapy at this congenital deformation of a thorax is inefficient. At II and III extents of deformation expeditious reconstruction of a thorax for creation of normal conditions for work of heart and lungs is shown. Operations are performed on reaching the child of age of 6-7 years. Traumatologists manage to achieve desirable result only at 40-50% of patients.
In recent years for treatment of this malformation the method of two magnetic plates is used. One plate is implanted for a breast, the second is established outside on a special corset. The external magnet tightens an internal plate of a kpereda, gradually eliminating in the way deformation of a thorax of the patient.
Keeled deformation of a thorax (chicken breast)
Pathology is caused by excess growth of costal cartilages. Usually cartilages of the V-VII edges expand. The breast of the patient acts forward, giving breasts the characteristic form of Kiel. The keeled thorax is followed by increase in the perednezadny size of a thorax.
In process of growth of the child violation of a form becomes more expressed, there is a major cosmetic defect. Internals and a backbone suffer slightly. Heart gets a drop form (trailing heart). Patients show complaints to short wind, bystry fatigue, heartbeat at physical activity.
Operation is shown only at dysfunction of internals and is not carried out to children 5 years are younger.
It is caused by uneven development of a thorax with reduction of its perednezadny size. Does not cause changes from bodies of a chest cavity.
The acquired deformations
Result from the postponed diseases (rickets, bone tuberculosis, pulmonary diseases, etc.). As a rule, also the side surfaces of a thorax are involved in process back.
Develops at chronic emphysema of lungs. The Perednezadny size of a thorax increases, the breast of the patient becomes barrel-shaped. Reduction of respiratory excursions is caused by a disease of lungs.
It is characterized by reduction of the perednezadny and side size of a thorax. Intercostal intervals are expanded, shovels lag behind a back, clavicles are well excreted. The asymmetric zapadeniye under - and supraclavicular poles and intercostal intervals, the asynchronous movement of shovels at breath is noted. Pathology is caused chronic to diseases of a pleura and lungs.
Arises at patients with a siringomiyeliya. It is characterized by boatshaped deepening in average and top parts of a breast.
Develops as a result of the pathological process in a backbone which is followed by the expressed change of its form that is confirmed at a X-ray analysis and KT of a backbone. Can arise at tuberculosis of a backbone and some other diseases. The expressed kifoskoliotichesky deformation causes violation of work of heart and lungs. Will badly respond to treatment.