Types of chest deformation in children, treatment by massage, exercises
The Pathology of the skeletal system are quite common. Chest deformity in children may be congenital or acquired. This may change the position of the internal organs, particularly the heart and lungs.
The Rib cage is a part of the body of the child. It is formed by the following structures: ribs, breastbone, spine and muscles. This bone frame restricts the chest cavity where the vital organs (heart, lungs, esophagus, trachea, thymus). Normal chest is a bit compressed in the anterior-posterior direction. Its main purpose – protection of internal organs.
Chest Deformity in a child is a pathological condition characterized by changes in the shape, size and volume of the thorax due to congenital or acquired malformations.
This condition not only poses a threat to the health of the baby, but also a serious cosmetic defect. In this disease decreases the distance between the spinal column and the sternum, which may facilitate the compression of bodies. This pathology is diagnosed more often in boys. There may be 2 types of chest deformation in children: congenital and acquired. The latter is based on the effects on the body of various harmful external and internal factors.
Most Often it occurs during active bone growth. With regard to a congenital defect, he may not display any signs. The progression observed in the period of rapid bone growth (ribs). The frequency of occurrence of chest deformation in children ranges from 0.6 to 2.3%. Today there are the following types of deformation of the chest:
- keeled (chicken)
- funnel (chest shoemaker);
- Poland syndrome
- split chest.
The last Three types are diagnosed very rarely.
Chest Deformity in children occurs due to certain reasons. The acquired form of pathology is formed on the background of the following predisposing factors:
- the incorrect posture of the child;
- tuberculosis of bones
- chronic lung disease
- tumors (chondroma, osteoma);
- traumatic injuries
- severe burns
- connective tissue diseases.
Less common cause of acquired deformity of chest in children are purulent diseases (osteomyelitis, abscess), tumors of the mediastinum, emphysema. Sometimes the cause may be surgery (thoracoplasty or sternotomy). Congenital curvature can be due to heredity or the effects on the fetus of various teratogenic factors. Impaired formation of the thoracic skeleton is one of the manifestations of Marfan syndrome.
In children and adolescents the shape of the chest may be altered in various diseases. It is often associated with pulmonary pathology. In medical practice often occurs in paralytic form of the thorax, barrel-shaped, kyphoscoliotic and navicular. Paralytic form of the thorax is formed on the background of pulmonary fibrosis. The volume of the lung tissue decreases. The size of the chest decreases. In such patients the shoulder blades stand out sharply. If the chest is like a barrel, it indicates the development of emphysema. The ribs are located more horizontally, and the spaces between them increase.
Gipokaliemicski type of chest can be formed in the case of human TB infection, and rheumatoid arthritis. The reason may be and curvature of the spine. When the navicular shape of the breast has a recess. It is formed in the middle or upper part of the sternum. The main reason of this disease – syringomyelia. Acquired deformity of the chest in most cases occurs between the ages of 5 to 8 and 11 to 15 years.
the Rib cage on the type of funnel
Funnel chest deformity related to a congenital malformation. Its main feature is the retraction of the ribs and costal cartilages. In this case, the depth of the retraction may be different. Depending on this there are 3 degrees of severity of pathology. Mild degree characterized by the depth of the crater up to 2 cm Treatment may be conservative (massage, exercises). When the second extent is equal to 3-4 cm of the funnel In this case, a shift in the hearts of 2-3 cm, With 3 degree heart changes position at 3 cm, and the recess is more than 4 cm Funnel chest deformity is diagnosed in 1 kid out of 300. In most cases this defect is gradually corrected, and to three years of deformation disappears. In more severe cases, the child subsequently becomes disabled.
In the overall structurecongenital funnel chest is about 90%. Along with the change of shape and volume of the chest these children have a rotation of the heart and curvature of the spine. The main cause of this disease is the disruption of the formation of hyaline cartilage tissue during fetal development. Funnel chest is dangerous because on the background of reducing the volume of the thoracic cavity may develop the following complications:
- increased blood pressure in the pulmonary circulation;
- inadequate oxygen saturation of blood;
- the functions of the authorities;
- violation of acid-base balance;
- muscle wasting
- irregular breathing.
These children, there is a risk of compression of the bronchi and changes in the location of large vessels. The symptoms of this disease depend on the age of the child. If the child is less than 1 year, possibly retraction of the ribs and sternum during inspiration. At preschool age contributes to the defect of frequent respiratory diseases (bronchitis, pneumonia). It is very often developed laryngotracheitis. Often such children is stridor. It differs in that there is difficulty in breathing. In addition, it identifies muscle tension, retraction of the abdomen.
Almost always, after 3 years of funnel chest causes curvature of the spine. Thoracic kyphosis becomes more pronounced. In some children arise lateral curvature of the spine. Most pronounced symptoms in older children. During this period you may experience the following symptoms:
- the protrusion of the abdomen;
- drooping of the shoulders;
- pale skin
- weight reduction
- shortness of breath
- increased blood pressure
- signs of bronchiectasis.
A Little less in children diagnosed after the birth of keeled chest. Boys suffer from this disease is approximately 3 times more often than girls. In girls this disease progresses at a younger age. Keeled chest is dangerous because it can lead to emphysema. All this contributes to the violation of gas exchange. Very frequently a keel-shaped chest combined with scoliosis.
The Main cause of this disease is excessive growth of cartilage in his ribs. Most often this violation is detected in the region of ribs 5-7. If in the previous case in the chest, there was a recess (funnel), then in this situation the opposite is true: the sternum protrudes forward. The main manifestations of the will of the body: tachycardia, configuration change of heart (it takes the form of drops), shortness of breath and low endurance. With age, the defect becomes more noticeable. The main method of treatment – surgical.
Diagnosis and treatment
Any qualified doctor, including renowned pediatrician Komarovsky, can reveal the deformity of the chest visually. However diagnosis must be comprehensive. It includes visual inspection, interviewing the child or parents physical examination (auscultation of the lungs and a heart murmur), an examination of the oral cavity and the entire skeleton of the child. For more exact information is x-rayed. Is also measured the depth of the funnel (funnel-shaped cage). Additional methods of diagnosis include ECG, Echocardiography, MRI of the heart, determination of vital capacity of the lungs.
Treatment of this disease can be conservative and surgical.
Conservative therapy is carried out in mild deformation and includes exercises, massage, swimming, the wearing of corsets.
If there is a congenital funnel chest deformity, conservative therapy is indicated only in 1 degree. Exercise, massage and other methods in this situation are to prevent progression of diseases, strengthen the muscles and ligaments, prevention of spinal curvature and increasing lung volume.
If exercises (physical therapy), massage and other therapies are ineffective, surgical intervention. During funnel chest surgery (plastic) is preferably carried out in the age of 12-15 years. Absolute indications for surgery are: severe funnel-shaped thorax deformation resulting in the breakdown of the psyche of the child, presence of a congenital cleft of the breast, Poland syndrome. Contraindications to surgery include mental retardation and severe concomitant diseases of the Central nervous system, heart and respiratory system. In congenital deformation the effect of thoracoplasty is very good. Thus, deformation of the thorax requires the attention of doctors and timely treatment.