The three major congenital chest wall deformities are PE, PC, and sternal cleft. They tend to be isolated defects with cosmetic, psychological, and physiologic consequences for young people. Treatment of all three deformities is primarily surgical. PE and PC are different in appearance but similar in etiology; until recently, correction consisted primarily of variations on the original procedures described by Ravitch more than a half century ago. With the introduction of the substernal Nuss bar, treatment of chest wall defects is currently evolving. Along with this relatively new therapy will come a reanalysis of the indications, timing, extent, and success of intervention.
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