Bone-cartilage proportion in deformed ribs of male pectus excavatum patients.
Bone-cartilage proportion in deformed ribs of male pectus excavatum patients.
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男性漏斗胸患者畸形肋骨骨软骨比例。
DOI：
10.1080/2000656x.2018.1554532
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Kogure T.
中科院分区：
文献类型：
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作者：
Nagasao T;Aizezi N;Noguchi M;Morotomi T;Kudo H;Kogure T.
本研究验证了男性漏斗胸患者变形肋骨中骨/软骨比例随年龄变化的假设。参照三维计算机断层扫描图像，对 79 名男性漏斗胸患者的胸廓进行了解剖学评估。将患者分为儿童组（5-9岁：n=≥35）；青少年组（12-15岁：n= 15）和成人组（18岁以上：n= 29）。对于每位患者，确定胸骨最凹的点，并将最靠近该点的一对肋骨定义为关键肋骨。在每个关键肋骨上，最腹侧点定义为突出点（PP）；骨和软骨之间的连接处被定义为肋软骨连接处（CCJ）。这些点距脊柱的距离分别定义为突出点距离 (DPP) 和肋软骨交界处距离 (DCCJ)。键肋的水平长度定义为肋长度(RL)。对 DPP/RL 和 DCCJ/RL 进行组间和组内比较。组间比较：成人组中的 DCCJ/RL 明显小于儿童组，DPP/RL 明显大于儿童组，这意味着随着患者年龄的增长，CCJ 向内侧移动，PP 向外侧移动。组内比较：在儿童组中，DCCJ/RL 显着大于 DPP/RL，这意味着 CCJ 存在于 PP 的侧面。相反，在成人组中，DCCJ/RL 明显小于 DPP/RL，这意味着 CCJ 存在于 PP 内侧。胸部凹部的骨/软骨比例根据患者的年龄而变化。为了有效地执行 Nuss 手术，必须考虑到这种与年龄相关的解剖变化。
This study verifies the hypothesis that bone/cartilage proportion in deformed ribs of male pectus excavatum patients varies according to their ages. Anatomical evaluation of the thoraces was performed for 79 male pectus excavatum patients, referring to their three-dimensional computer-tomographic images. The patients were divided into Child Group (5–9 years old:n= 35); Adolescent Group (12–15 years old:n= 15) and Adult Group (18+ years old:n= 29). For each patient, the most concave point of the sternum was identified and the pair of ribs closest to the point were defined as Key Ribs. On each Key Rib, the most ventral point was defined as Prominent Point (PP); the junction between the bone and cartilage was defined as Costo-Chondral Junction (CCJ). The distances of these points from the spine were defined as Distance of Prominent Point (DPP) and Distance of Costo-Chondral Junction (DCCJ), respectively. The horizontal length of the Key Rib was defined as Rib Length (RL). Inter- and intra-group comparisons were performed for DPP/RL and DCCJ/RL. Inter-Group Comparison: DCCJ/RL is significantly smaller and DPP/RL is significantly greater in Adult Group than in Child Group, meaning CCJs shift medially and PPs shift laterally as patients get older. Intra-Group Comparison: In Child Group, DCCJ/RL is significantly greater than DPP/RL, meaning CCJs exist lateral to PPs. Contrarily, in Adult Group, DCCJ/RL is significantly smaller than DPP/RL, meaning CCJs exists medial to PPs. Bone/cartilage proportion in the concave part of the chest shifts according to patients’ ages. To perform the Nuss procedure effectively, this age-related anatomical change must be taken into consideration.