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Sternum --- Luxations.

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Mammals. --- Manubrium. --- Sternum.

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Bone and Bones --- Clavicle --- Sternum

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Objective: The Vacuum Bell (VB) is a new therapeutic tool in the conservative treatment of patients with Pectus Excavatum (PE). Based on our experience at Saint-Luc university clinics, we wanted to evaluate its effectiveness, its methods of use and determine its target population. Method: We followed 32 patients who started a VB corrective treatment at the Saint Luc university clinics between May 2014 and August 2017. Several data were collected and then statistically analyzed using the IBM SPSS program. Finally, we compared our results with those published in the literature. Results: We observed a reduction in the depth of PE in ail patients except for two of them. Subsequently, we analyzed our results by comparing two distinct groups: one for which the final PE depth was > 15 mm (group 1) versus one for which the depth after treatment, ≤ 15 mm (group 2). We observed a significant difference in terms of initial depth of deformation as well as reduction differences in depth percentage. Comparisons of daily duration of application, total duration of treatment and age did not yield statistically significant differences.Conclusion: The conservative management of PE by the VB technique seems to be a promising additional option in the practitioner's therapeutic arsenal. The conservative technique is not intended to replace surgery, but could provide an alternative first approach. Patients with moderate initial PE depth (24mm on average) had a more satisfactory result than those with a more severe deformity (37mm on average).Although we did not obtain a statistically significant difference for the other parameters under consideration, in view of our experience and the literature analysis, we advise to start treatment before puberty for two hours per day during one year. Objectif : La Vacuum Bell (VB) est un nouvel outil thérapeutique dans le traitement conservateur des patients atteints de Pectus Excavatum (PE). Sur base de notre expérience au sein des cliniques universitaires Saint-Luc, nous avons voulu évaluer son efficacité, ses modalités d'utilisation et déterminer sa population cible. Méthode : Nous avons suivi 32 patients qui ont entamé un traitement correctif par VB aux cliniques universitaires Saint Luc entre mai 2014 et août 2017. Bon nombre de données ont été récoltées et ont fait ensuite, l'objet d'une étude statistique via le programme IBM SPSS. Enfin, nous avons comparé nos résultats à ceux parus dans la littérature. Résultats : Nous avons observé une réduction de la profondeur du PE chez tous les patients à l'exception de deux. Par la suite, nous avons analysé nos résultats en comparant deux groupes distincts : un pour lequel la profondeur finale du PE était > à 15mm (groupe 1) contre un second pour lequel la profondeur après traitement était ≤ à 15mm (groupe 2). Nous avons observé une différence significative en termes de profondeur initiale de la déformation et de différence de réduction en pourcentage de la profondeur. Les comparaisons de durée d'application quotidienne, de durée totale du traitement et d'âge, n'ont pas atteint le seuil de signification statistique. Conclusion : La prise en charge conservatrice du PE par la technique de VB nous parait être une option supplémentaire prometteuse dans l'arsenal thérapeutique du praticien. La technique conservative n'a pas pour objectif de remplacer la chirurgie mais pourrait être une alternative de choix comme première approche. Les patients ayant une profondeur initiale de PE modérée (24mm en moyenne) obtiennent un résultat final plus satisfaisant que ceux ayant une déformation plus marquée (37mm en moyenne).Bien que nous n'ayons pas obtenu de différence statistiquement significative pour les autres éléments, au vu de notre expérience et de l'analyse de la littérature, nous conseillons de commencer le traitement avant la puberté à raison de deux heures par jour sur une durée d'un an.

Retrospective Studies --- Funnel Chest --- Musculoskeletal Abnormalities --- Sternum --- Suction

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These congenital deformities, funnel or keel chest deformities, as well as Poland syndromes, affect a small group of patients who suffer from aesthetic rather than functional impairment. The wide variety of diagnoses and recommended therapies, mostly surgical procedures, can be very confusing for patients, their parents, physicians and surgeons. In recent years several techniques have been refined and developed to deal with these complex problems, and surgeons with different specialties have been operating on these deformities, mostly as lonely experts in their respective fields. This book should not be seen as an operation atlas but more as a compact survey of a small group of medical conditions and the need for flexible options for an individual therapeutic approach, based on the combined experience of different international specialists. Thus the book is designed for obstetricians, pediatricians, physicians and surgical specialists alike.

Chest -- Abnormalities. --- Chest -- Surgery. --- Surgery, Plastic. --- Thorax --- Surgical Procedures, Operative --- Body Regions --- Analytical, Diagnostic and Therapeutic Techniques and Equipment --- Bone and Bones --- Skeleton --- Anatomy --- Musculoskeletal System --- Ribs --- Thoracic Wall --- Sternum --- Reconstructive Surgical Procedures --- Surgery & Anesthesiology --- Health & Biological Sciences --- Surgery - General and By Type --- Chest --- Surgery. --- Abnormalities. --- Thoracic surgery --- Medicine. --- Plastic surgery. --- Thoracic surgery. --- Medicine & Public Health. --- Plastic Surgery. --- Thoracic Surgery. --- Thoracic surgeons --- Surgery, Primitive --- Medicine --- Aesthetic surgery --- Cosmetic surgery --- Plastic surgery --- Reconstructive surgery --- Surgery, Aesthetic --- Surgery, Cosmetic --- Surgery, Reconstructive --- Transplantation of organs, tissues, etc. --- Plastic surgeons