Pectus Bar Dislocation: Comparison Between Three Different Stabilization Techniques Adopted in a Single Centre

Infographic · Aug 2024 · 1 min read

In brief

This single-center study of 468 patients compared three stabilization techniques for minimally invasive pectus excavatum repair. Bridge fixation eliminated bar dislocation entirely (0%) compared to 8.8% without stabilizers and 4.8% with single-bar fixation, establishing it as the preferred stabilization method.

Bar dislocation after MIRPE occurred in 8.8% without stabilizers, 4.8% with single-bar fixation, and 0% with bridge fixation technique.
Bridge fixation eliminated bar dislocation entirely in 205 bars over 10 years, making it the preferred stabilization method.
Any stabilization technique significantly reduces dislocation risk compared to no stabilizer in pectus excavatum repair.
Dislocation defined as bar rotation >30° or lateral displacement >1.5 cm occurred in 4.1% overall across 733 bars in 468 patients.
Single-center experience demonstrates bridge fixation's superiority for preventing the most feared complication of minimally invasive pectus repair.

Written by the GCMD Library team from the infographic.

The infographic uses a three-column layout with a red sidebar on the left containing study metadata. The center column shows anatomical diagrams of the chest with a pectus bar, illustrating three different fixation approaches. The right column displays dislocation percentages in large teal numbers with an anatomical diagram showing bar displacement. Icons and simple line drawings illustrate each technique.

Francesco Donati, Maria Stella Cipriani, Angela Pistorio, Vittorio Guerriero, Girolamo Mattioli, Michele Torre

Background: Bar dislocation has always been considered a fearsome complication of Minimally Invasive Repair of Pectus Excavatum (MIRPE), therefore multiple techniques and types of stabilization have been introduced. The aim of the study is to compare different stabilization techniques in a cohort of patients operated by the same first operator.

Methods: MIRPE was adopted at our institution in 2005. Data on MIRPE patients from January 2013 to December 2022 were collected prospectively and reviewed. Patients with a follow-up of at least 12 months were included. Throughout the years different ways of stabilization were used. Patients were divided in 3 groups according to the stabilization strategy adopted- Group A: no stabilizer; Group B: single bar fixation; Group C: bridge fixation. Dislocation was diagnosed if a bar rotated more than 30° or displaced laterally for more than 1.5 cm. We compared bar dislocation percentage of each group.

Results: We positioned 733 bars in 468 patients. Group A included 113 bars (15.4%), Group B 415 bars (56.6%), Group C 205 bars (28%). No patients were lost at follow-up. Total dislocation rate was 4.1% (30 bars). Dislocation was observed in 10 bars of group A (8.8%), 20 bars of group B (4.8 %), 0 bars of group C (0%). Differences between groups were statistically significant.

Conclusions: The use of stabilizers reduced dislocation percentage. In particular, bridge fixation technique reduced to zero bar dislocation and is now our preferred technique of stabilization.

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