2.3. Transverse Sternal Osteotomy+Minimally Invasive Nuss Procedure

The surgical procedure was implemented to treat a pouter pigeon breast comorbid with pectus excavatum. A transverse incision was made at the sternal protruding site, and the protruding sternum was wedge resected. The broken end of the sternum was sutured by a steel wire. The protruding costal cartilages were resected from the periosteum on both sides of the sternal protruding site. A polyester suture was used to reapproximate the broken ends of the costal cartilages. The Nuss procedure was implemented at the lowest level of the sternal depression site. The steel bar was inserted and flipped over to flatten the depressed chest wall (Figure 6).

Pectus carinatum (pouter pigeon breast) comorbid with pectus excavatum: (a) preoperative appearance, (b) postoperative appearance and surgical incisions, (c) preoperative lateral chest X-ray film, and (d) postoperative anterior and lateral chest X-ray films.

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