Page 34 - Waterfall_Issue 3_March_2022

Waterfall News

This patient fell pregnant and was t Pectus excavatum severe case
bedbound by her third trimester. She
subsequently had her pectus repaired t Pectus excavatum minor case
before her second pregnancy, which was
uncomplicated, and she was gardening
up to the moment she went into labour.

The second patient was unable to
partake in any physical activity at school.
Following the repair, she now represents
her province as a drum majorette.
qualified consultant at Edendale attending his own clinical meeting.
The third patient is a young teenager Hospital, he noticed that his colleagues He decided to emigrate to the United
who has since become a professional of colour were being paid less than States. While doing an old-fashioned
athlete after the repair of his pectus he was. This was the norm during open repair of a pectus excavatum, he
excavatum. These and other stories Apartheid, and Nuss, as a young says he was hit like a bolt of lightning.
can be accessed at www.pectus.co.za activist, wrote a letter to the Minister of ‘If a dentist can repair crooked teeth
Health pointing out the discrepancy. and an orthopaedic surgeon can
The repair of pectus excavatum has correct clubfeet, why can’t the thoracic
been revolutionised by a South African The following week he was visited by surgeon do the same to the chest?’
professor, Donald Nuss. As a newly the security police and banned from
This was the beginning of his research
that has culminated in the minimally
invasive Nuss repair. This operation
involves small cosmetic incisions on each
side of the chest wall with the insertion
of a stainless steel bar, placed to push
the chest into a normal position. This
operation avoids any cutting of the
bone, allowing the patient to partake
Pectus bars post-operative
in full contact sport after recovery.

The second condition, pectus carinatum,
is when the chest bone is pushed
outwards. This is the so-called pigeon
chest. The pectus carinatum has no
effect on the heart but the prominent
sternum often gets traumatised,
especially during sport, and patients are
very conscious of the deformity with
Post-operative patient resultant psychological problems.

Treatment has the same principles
but in this case the compression can
be performed without an operation.
The first option is a chest brace, which
Pre-operative pectus excavatum
has the identical principles of dental
braces. The brace is adjusted as the
condition improves until there is total
correction. In the young, surgery
is seldom required. Older patients
however have a stiffer chest wall and
compression is often unsuccessful.

We are now 3D printing the braces in
South Africa at a considerable saving
Pectus carinatum brace Post-operative result compared to the imported braces.

32 Waterfall Issue 3 2022