Home Adviсe Chicken breast in a child. How is the diagnosis carried out?

Chicken breast in a child. How is the diagnosis carried out?

Types of deformation

funnel-shaped(depressed), these changes are due to the fact that the sternum (the bone in the center of the chest) goes deep, it is also called the “shoemaker's chest”.
keeled(rachitic), when the sternum protrudes strongly forward. It is compared to the keel of a ship. This condition is otherwise called “chicken breast”;
dysplastic chest(flat), with it a decrease in the volume of the sternum is noticed.

Causes of pathology

Congenital ones include:

genetic factors;

Symptoms

up to 2 cm - first degree;

up to two cm - first degree;

Diagnostics

chest x-ray;

breathing exercises;
therapeutic massage;

When diagnosing more severe forms of deformity, surgical intervention is used. Experienced orthopedic doctors perform surgeries to change the deformation of a child’s chest. In 90-95 percent of cases, a positive outcome of the operation is achieved.

Diagnostics

Doctor Komarovsky about rickets

Rickets is a diagnosis that frightens parents of children even more than the flu. Since childhood, mothers and fathers have had their grandmother's frightening stories firmly ingrained in their heads: that if you eat poorly, terrible rickets will definitely happen.

Girls and boys have grown up, become parents themselves and already know that rickets has nothing to do with the amount of food eaten, but this does not make the questions any less, especially if the local pediatrician, during the next examination of the baby, sighs sadly and says that the baby has a condition close to rickets or even some degree of rickets. The famous pediatrician Evgeniy Komarovsky talks about what it is and whether you should be afraid of it.

About the disease

Rickets is a typically childhood disease. It is associated with insufficient bone mineralization and improper formation of skeletal bones. This condition occurs when the baby is actively growing, and his body is pathologically lacking vitamin D. Rickets can be associated with a lack of calcium, phosphorus, and sometimes it occurs when completely normal indicators of these substances in a blood test. The disease can be acute, subacute and recurrent, and also has three degrees of severity.

Rickets begins, gains momentum, and then goes away on its own, leaving only signs for doctors to examine past illness. Secondarily, the disease develops quite rarely, mainly against the background serious illnesses kidney disease, serious metabolic disorders, and in children who have been given anticonvulsants for a long time.

It is believed that rickets most often occurs in children born in winter or late autumn, as well as those living in regions whose climatic conditions do not allow frequent exposure to the sun, or in regions with unfavorable environmental conditions (smoke, air pollution, low amount of sunshine). days a year).

Breast-fed babies are more likely to develop rickets than babies who are fed breast milk, since the former absorb only 30% of calcium, while the latter absorb up to 70%. Vitamin D deficiency interferes with calcium absorption.

The main source of this important vitamin- the sun's rays that fall on the child's skin.

Medicine considers classic signs of rickets to be sleep disturbance in an infant, tearfulness, poor appetite, fearfulness (when the baby flinches from loud sounds), sweating, especially night sweating, baldness of the back of the head, with which the baby rubs against a diaper or pillow due to itching of the scalp. The smell of the patient's sweat has a sour, specific odor. All these symptoms are characteristic of the initial stage of the disease, which can last about a month.

During the active stage of the disease, various disorders begin skeletal system, softening of bones, deformation, the child may experience delayed mental and physical development. Typical signs- rickety “rosary beads”, “bracelets” and “strings of pearls”. With such beautiful names, medicine denotes not very beautiful manifestations of thickening of the junction cartilage tissue into the bone. “Bracelets” are on the arms, “rosaries” are on the ribs, “strings of pearls” are on the fingers. Another visual sign is also called quite poetically - “Olympic forehead”. It manifests itself in a noticeable protrusion of the frontal bone forward.

Then the disease subsides, leaving the child with the consequences of rickets for the rest of his life - poor posture, deformation of the chest, changes in the bones of the legs. The disease is considered especially dangerous in girls, since the narrowing of the pelvic bones, which may remain after suffering from rickets, may cause difficulties in the future during natural childbirth. For such girls and women, a caesarean section is recommended.

Doctor Komarovsky about rickets

Modern pediatricians are very fond of this diagnosis. Firstly, because it relieves the doctor of all responsibility for possible problems in the development of the baby (anything can happen, but they warned us - rickets!), and, secondly, it is as difficult to refute it as it is to prove it. In this case, the doctor makes a diagnosis that does not exist, for example, rickets of 0-1 degree. There is no such disease, says Komarovsky. And grade 1 rickets, if desired, can be found in nine out of ten young children. In 99% of these guys, the signs of rickets will go away on their own.

If the doctor told you that the child has rickets and did not order additional tests, you don’t have to worry - there is no rickets.

If the doctor has reason to suspect real rickets (and this happens very rarely), then he will definitely give a referral for an X-ray examination of the bones of the lower extremities and forearm, and recommend donating blood for vitamin D, calcium, and phosphorus levels.

Nowhere in the world is rickets diagnosed based on signs such as chest deformation, sweating or loss of appetite. And baldness of the back of the head is not considered a sign of rickets at all, according to Komarovsky, just the thin hair of a newborn, when he begins to turn his head (by 3-4 months), is mechanically “wiped” on the diaper, and no pathological reasons there is no need to look for this.

In 90% of cases, a baby's sweating is associated with incorrect temperature conditions in the apartment where he lives, as well as with the fact that his parents do not know how to dress him wisely and, as a result, simply wrap him up.

A crooked chest can generally be hereditary; just take a close look at the chest of your father, grandfather, or great-grandfather. If there is no family pattern, then again there is no reason to worry, because when the need for calcium becomes less, when bone growth slows down somewhat, all the imperfections and curvature will go away by themselves.

But most pediatricians stubbornly do not want to notice modern world standards for diagnosing this disease; they continue to use in their work information published by medical textbooks 50 years ago, and therefore the number of children who, due to sweaty feet and a bald head alone, were given a verdict of “rickets” in Russia today is approaching 70% of the total number of newborns and infants, while only 1 % of children.

Treatment according to Komarovsky

Most often, doctors who have diagnosed a child with rickets prescribe shock doses of vitamin D and pine-salt baths. Such water procedures are very useful for children's health, but they have nothing to do with the treatment of real rickets, says Komarovsky. Prescribing loading doses of vitamins is generally a medical crime. The maximum amount that a child should be given is no more than 500 units per day or 1 drop aqueous solution"Aquadetrim". An overdose in a baby can cause severe vomiting, diarrhea, urinary dysfunction, increased blood pressure and even the development of cardiopathy and cardioneurosis.

If you don’t want to expose your child to such a risk, you don’t have to rush to follow the recommendations to take the vitamin in lethal doses, especially in the summer, when walking outside is already a good way to replenish the deficiency of the substance in the body. The dosage should be taken more than reasonably.

Walks and fresh air for a child with rickets (or suspected of it) are very useful. You should definitely include porridges or mixtures containing vitamins in your baby’s diet. It would not hurt to consult a good pediatric otropedist, who, based on x-rays of the long bones of the legs (tibia) and forearm, will dispel or confirm fears. In the second case, he will certainly give his recommendations.

If rickets is associated with a lack of phosphorus, calcium, as well as a deficiency of vitamin D, and this is confirmed by laboratory tests, newborns are treated with cholecalciferol. Depending on the test results, calcitriol may be prescribed. This is not enough for premature babies; they are recommended to take calcium gluconate and potassium phosphate.

The prognosis for most children with real, not fictitious, rickets is quite favorable. But what parents should definitely make sure of is the absence of calcium deficiency; it is more common in children than rickets, both together with it and separately. If blood tests show this deficiency, then it is worth starting to give the child calcium supplements in strictly age-specific dosages.

Prevention

Prevention of rickets is not something expensive, complicated or difficult. And therefore, says Komarovsky, it is necessary to deal with it without fail. If the baby is on natural feeding, vitamin D should be taken by a nursing mother, the baby will receive its dose with milk.

Artificial babies, especially those born in winter, can be given the vitamin from almost birth (from the second or third week), but if he eats an adapted formula, then it already contains this substance. Once a baby who is fed his mother's breast milk, complementary feeding makes up about a third daily ration, he needs to be given vitamin D if he is cooked with regular milk.

If baby porridge already contains it (and most of these modern instant porridges do) or is prepared using an adapted mixture that also contains this vitamin, then there is no need to take the drug separately.

Half an hour in the sun per day covers the daily requirement for vitamin D. If there is little sun (from October to March in most regions of Russia), then vitamin preparations should be taken strictly in the age-specific dosage. An overdose of this vitamin is worse than its deficiency.

You can learn more about rickets from the following program by Dr. Komarovsky.

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Source: chest deformities in children, treatment with massage, exercises

Pathologies of the skeletal system are quite common. Chest deformity in children can be congenital or acquired. In this case, the position of internal organs, in particular the heart and lungs, may change.

The rib cage is part of the baby's torso. It is formed by the following structures: ribs, sternum, spine and muscles. This bone frame limits the chest cavity, in which the vital important organs(heart, lungs, esophagus, trachea, thymus). Normally, the chest is slightly compressed in the anteroposterior direction. Its main purpose is to protect internal organs.

Types of pathology

Chest deformity in a child is a pathological condition characterized by changes in the shape, size and volume of the chest due to congenital or acquired malformations.

This condition not only poses a threat to the baby’s health, but is also a serious cosmetic defect. With this disease, the distance between the spinal column and the sternum decreases, which can contribute to compression of organs. This pathology is diagnosed most often in boys. There are 2 types of chest deformation in children: congenital and acquired. The latter develops against the background of exposure to various harmful external and internal factors on the body.

Most often this happens during active growth bones. As for a birth defect, it may not manifest itself for a long time. Progression is observed during a period of intensive bone (rib) growth. The incidence of chest deformity in children varies from 0.6 to 2.3%. Today, the following types of chest deformation are distinguished:

The last three types are diagnosed very rarely.

Etiological factors

Chest deformation in children occurs for certain reasons. The acquired form of pathology is formed against the background of the following predisposing factors:

Less common causes of acquired chest deformation in children are purulent diseases (osteomyelitis, phlegmon), mediastinal tumors, and emphysema. Sometimes the cause may be surgical operations (thoracoplasty or sternotomy). Congenital deformities can be caused by heredity or exposure to various teratogenic factors on the fetus. Violation of the formation of the thoracic frame is one of the manifestations of Marfan syndrome.

Acquired deformity

In children and adolescents, the shape of the chest can change due to various diseases. Most often this is associated with lung pathology. IN medical practice Often there is a paralytic shape of the chest, barrel-shaped, kyphoscoliotic and scaphoid. The paralytic form of the chest is formed against the background of pulmonary fibrosis. At the same time, the volume lung tissue decreases. The size of the chest decreases. In such patients, the shoulder blades stand out sharply. If the chest becomes barrel-shaped, this indicates the development of emphysema. In this case, the ribs are positioned more horizontally, and the spaces between them increase.

The kyphoscoliotic type of chest can form if a person has a tuberculosis infection or rheumatoid arthritis. The cause may also be a curvature of the spine. With a scaphoid breast, there is a depression. It forms in the middle or upper part of the sternum. The main cause of this disease is syringomyelia. Acquired chest deformity in most cases occurs between the ages of 5 to 8 and 11 to 15 years.

Funnel-shaped chest

Pectus excavatum is associated with a congenital malformation. Its main feature is the retraction of the ribs and costal cartilages. In this case, the depth of retraction can be different. Depending on this, there are 3 degrees of severity of the pathology. Mild degree characterized by a funnel depth of up to 2 cm. Treatment in this case can be conservative (massage, exercises). In the second degree, the size of the funnel is 3-4 cm. In this case, a displacement of the heart by 2-3 cm is observed. In the 3rd degree, the heart changes position by 3 cm, and the depression is more than 4 cm. Funnel-shaped deformity of the chest is diagnosed in 1 baby out of 300. In most cases, this defect is gradually corrected and by three years the deformity disappears. In more severe cases, the child subsequently becomes disabled.

IN general structure of congenital defects, pectus excavatum accounts for about 90%. Along with changes in the shape and volume of the chest, such children experience rotation of the heart and curvature of the spine. The main cause of this disease is a violation of the formation of hyaline cartilage tissue during intrauterine development. Funnel chest is dangerous because, against the background of a decrease in the volume of the chest cavity, the following complications may develop:

promotion blood pressure in the pulmonary circulation;
insufficient blood oxygen saturation;
organ dysfunction;
violation of acid-base balance;
muscle atrophy;
breathing disorder.

Such children have a risk of compression of the bronchi and changes in the location of large vessels. Symptoms of this pathology depend on the age of the child. If the child is less than 1 year old, the ribs and sternum may retract during inspiration. In preschool age, the defect contributes to frequent respiratory diseases(bronchitis, pneumonia). In this case, laryngotracheitis very often develops. Often these children exhibit stridor breathing. It differs in that there is difficulty in inhaling. In addition, muscle tension and abdominal retraction are determined.

Almost always, after 3 years, pectus excavatum leads to curvature of the spine. Thoracic kyphosis becomes more pronounced. Some children develop lateral curvatures of the spine. Symptoms are most pronounced in older children. During this period, the following symptoms may appear:

Keel shape

Slightly less often, children are diagnosed with keeled breasts after birth. Boys suffer from this disease approximately 3 times more often than girls. In girls, this pathology progresses at a younger age. Keeled breasts are dangerous because they can lead to emphysema. All this contributes to disruption of gas exchange. Very often, keeled breasts are combined with scoliosis.

The main cause of this pathology is excessive growth of cartilage tissue in the ribs. Most often, such a violation is detected in the area of 5-7 ribs. If in the previous case there was a depression (funnel) in the chest, then in this situation the opposite is true: the sternum protrudes forward. The main manifestations from the body will be: tachycardia, changes in the configuration of the heart (it takes the shape of a drop), shortness of breath and low endurance. With age, the defect becomes more noticeable. The main method of treatment is surgical.

Diagnosis and treatment

Any experienced doctor, including the famous pediatrician Komarovsky, can detect chest deformation visually. Nevertheless, the diagnosis must be comprehensive. It includes a visual examination, interview of the child or his parents, physical examination (listening to lungs and heart sounds), examination of the oral cavity and the entire skeleton of the child. To obtain more accurate information, an x-ray examination is performed. The depth of the funnel is also measured (for a funnel-shaped cell). Additional Methods diagnostics include ECG, EchoCG, MRI of the heart, determination of vital capacity of the lungs.

Treatment of this pathology can be conservative and surgical.

Conservative therapy is carried out for mild deformities and includes exercises, massage, swimming, and wearing special corsets.

If there is congenital pectus excavatum deformity, conservative therapy is indicated only for grade 1. Exercises, massage and other methods in this situation are carried out with the aim of preventing the progression of pathology, strengthening muscles and ligaments, preventing spinal curvature and increasing lung capacity.

If exercises (physical therapy), massage and other methods of therapy are ineffective, surgical intervention is performed. With funnel chest surgical treatment(plastic surgery) is preferably performed at an older age. Absolute indications to the operation are: severe degrees funnel chest, deformations that caused mental disorders in the child, the presence of congenital cleft chest, Poland syndrome. Contraindications to surgery include mental retardation and heavy concomitant diseases CNS, heart and respiratory system. For congenital deformities, the effect of thoracoplasty is very good. Thus, chest deformation requires close attention from doctors and timely treatment.

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Source: there are mothers whose children have chest deformities

Redness and itching in a child

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Comments

Hello, today we visited the surgeon with our elder (we are undergoing a medical examination at the kindergarten), she said that He has a chest deformity. It’s minor, but to avoid future risks of pathology for the heart and spine, you need exercise therapy and special massage. I ask: why would this happen? He says: rickets. I never had rickets and never diagnosed. The orthopedist said that I have been swimming and playing sports since I was 4 years old. We take vitamin D regularly. I don’t know whether to be afraid or not

I have the same problem, not a big deformity, they also say I should take up swimming

I have a friend. from a medical point of view, I can’t say anything, I don’t know))) Love and praise more, my friend never had a complex about this, she calmly put on swimsuits and tops, that’s how unusual I say!))))))))) Plus On top of everything, she says, if you look from above, my one-year-old looks like 2+)))))))))) Now she has a wonderful husband and a 3-year-old son. I wish you health, but I actually wrote that if we can’t change something, we can change our attitude towards it))). And if he also goes in for sports, that will be just great!) By the way, there’s only one problem - she does have it - during fluorography she draws attention to this every time, because in the picture the deformation gives a shadow

Have you taken vitamin D?

Gave it didn't help

no let's go take it tomorrow

Eto odin iz priznakov rahita. From vitamin D i depend

My son has a deformity. We have a keeled form of deformation. While not clearly expressed, the ribs below seem to be sticking up. If you look closely and feel it, you can feel it. The surgeons don't say anything either. Everything, as usual, like all children, needs physical education, swimming, massages. And so, they said that this would not be corrected. The situation needs to be corrected surgically even when there is actually compression of the internal organs, or it looks very bad aesthetically, and many people live with this all their lives. I also read sooo much about this.

but didn’t go to an osteopath

Pochemu imenno k osteopatu?

Well I heard they work miracles

I should go too. We, too, according to several rehabilitation specialists, have problems. I really don't see them...

Well, every doctor has his own opinion

My son categorically does not let anyone near him. We tried to go to a very good massage therapist. As a result, I barely made it through one session. Children's massage therapist, the best in the city. He said that for now the massage will not bring any benefit. In a psychological sense. So for now we're waiting. We'll try again in a year)

I called the physiotherapist and they told me that it could probably be fixed.

I don’t know how much I understood from all my consultations and the Internet that you can only strengthen pectoral muscles so that it is not very noticeable. And it can only be completely corrected through surgery.

Well, yes, basically everyone writes like that, but some mothers on the forums wrote that after physiotherapy or some other measures, mainly gynastics and sports, that there was an improvement. Now I’ve actually read that this is one of the symptoms of connective tissue dysplasia. There are still a lot of side effects, it could be not just this kind of cell. I'm afraid this is genetic in us too. then such children often suffer from bronchitis and various diseases of the heart and lungs - unless, of course, the degree of deformation of the cell is quite large and interferes with the internal organs

We have genetics, my husband and his father have this. Not very pronounced. But still (

Do they have any other signs of connective tissue dysplasia?

Well. There are many signs of connective tissue dysplasia. In general, I think that every person can find at least one of the signs.

Source: chest of a child Komarovsky

When I found out, I was shocked, because there are no pathologies anywhere in the family at all. and here it is. I cried for several days in a row.

Then I pulled myself together and began to study literature on the internet.

We have already conducted one massage course, we will repeat it in 1.5 months. I work with my baby in the bathroom - he loves to swim. We constantly do exercises aimed specifically at the chest.

Of course, it’s easy to say - this is not their child.

Is it possible to cure without surgery?

I've been to other doctors, but they don't give me a degree either.

We have already gone to the Kozyavkin center twice for treatment - they also said that the muscles should grow and then the defect will disappear.

How many months or years is your child? and how do you do it?

I started taking care of the child right away, I’m afraid of the consequences, and so that they don’t make fun of me. In the summer I wouldn’t even let you into the dacha without a T-shirt. Only my husband and mother know, but we hide it from everyone.

And how do you see results in 1.5 years? is it very visible?

With regard to such deformations, they need to be observed in dynamics; if there are no deviations in the functioning of the heart and lungs, as well as an increase in the defect, then it is not very scary. If you have a girl, then your breasts will eventually grow, and the lower protruding ribs will not be very noticeable. What if it's a boy? Just look at bodybuilders - a mountain of muscles and not a single bone in sight. Subsequently, choose a sport.

The main thing is not to create complexes yourself. The child is yours and you love him more than anyone, and this is the main thing.

The complex is that I think about his future, so that later I myself do not have a complex, and so that my peers do not.

We also thought about sports. Doctors said that it does not affect the organs.

I understand that you are having a boy? Do you go to kindergarten? And does he notice it himself? Even though he’s small, he shouldn’t.

People, of course, are evil (those who are not all right themselves), nurture your child’s self-confidence and do not create complexes yourself.

What sport did you decide to enroll your daughter in?

In general, my husband dreams of football!

My daughter is 2 years old. From the age of 3 months we were diagnosed with pectus excavatum. I was also worried, I couldn’t find a place for myself, especially when I read on the Internet all the consequences of this pathology, my hair stood on end. but you get used to everything. I'm used to this situation. I don’t want to upset you, but massages and gymnastics in this case are not particularly effective! The disease reaches its maximum by the age of 3, and then it will be clear what degree of deformation you have.

so for now I live with this, I love my child and inspire him that he is the best and most beautiful and of course I hope that the deformity will remain the first degree.

We are already 9 months old, and thank God there is no deterioration... everything remains the same. The only thing I noticed is that the baby is growing very actively, and compared to the breast, this pathology has become smaller in size.

you see, it means some people have results!

But I’m wondering, is it hereditary for them, that it showed up in two children?

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Source: Chest deformities in a child: what to do and how to correct?

Chest deformation in children is a congenital or acquired change in the physiological shape, volume and size of the sternum. And there can be many reasons for this pathology. What to do and how to treat the disease? Let's look at everything in order...

The chest is a kind of musculoskeletal frame of the infant and adolescent body. Due to deformation of the sternum, children may experience various functional disruptions in the body, for example, the respiratory system, cardiovascular, and also mental. Psychological disorders can be caused by a child’s complexness due to his external defect.

Types of deformation

There are the following types this pathology:

funnel-shaped (depressed), these changes are due to the fact that the sternum (the bone in the center of the chest) goes deep, it is also called the “shoemaker's chest”.
keeled (rachitic), when the sternum protrudes strongly forward. It is compared to the keel of a ship. This condition is otherwise called “chicken breast”;
dysplastic chest (flat), with it there is a decrease in the volume of the sternum.

Causes of pathology

There are two causes of sternum deformation in children – congenital and acquired.

Congenital ones include:

genetic factors;
disruption of the formation of the skeleton (sternum, ribs, spine, shoulder blades) at the time of an increase in the volume of cartilaginous and bone tissue of the child’s chest in the womb.

Acquired causes of deformity include various chronic diseases:

Symptoms

Transformation of the chest manifests itself in different ways, depending on the type of deformation and the age of the child.

Pectus excavatum in children (sunken chest)

This type of pathology is observed in children much more often. The reason is insufficient development of the costal cartilages in the thoracic area (central or lower parts) and a depression appears.

There are three degrees of funnel deformation:

up to 2 cm - first degree;
from two to four cm - second degree;
more than four cm - third degree.

Deformations can have great differences: depressions can be narrow and deep, or vice versa, wide and shallow. Unilateral retraction of the sternum is often observed.

In children under 3 years of age, it is very difficult to determine the symptoms of the disease. These manifestations are most often associated with prolonged, frequently recurring viral diseases which can progress to pneumonia.

Children 7-10 years old and older experience difficulty breathing during and after physical activity, often experience fatigue and chest pain. They suffer from viral infections much more often than their peers.

20% of children have a lateral curvature of the spine. IN severe cases The functioning of organs such as the heart and left lung may be impaired.

Pileated chest deformity in children (protruding chest)

It occurs much less frequently in children. The main reason is excessive growth of the cartilage of the 5th and 7th ribs. It also has three degrees of severity:

up to two cm - first degree;
from two to four cm - second degree;
from four cm - third degree.

To a greater extent, the keeled chest deformity in a child has a cosmetic defect - a strong protrusion of the sternum forward. In addition, the child experiences difficulties in performing physical exercise, chest pain.

Diagnostics

In order to determine the exact diagnosis, the severity of the disease and what to do next, you need to undergo a full examination by a pediatric orthopedic doctor with all clinical and instrumental methods.

Chest deformity can be diagnosed through two studies:

chest x-ray;
magnetic resonance and computed tomography;

The orthopedic doctor also prescribes diagnostics of the respiratory system, heart and blood vessels to identify the presence or absence of pathology.

How to correct the situation that has developed with a child? Famous doctor Komarovsky advises parents not to panic. Treatment for deformity depends on the type and severity of the disease. For minor chest deformation in a child, conservative treatment methods are used. For example, such as physiotherapeutic measures, wearing individual medical corsets, massage techniques, physical therapy exercises.

Activities that need to be carried out in postoperative period:

breathing exercises;
therapeutic massage;
a set of physical exercises;
taking analgesic medications for pain relief;
Regular clinical trials.

When diagnosing more severe forms of deformity, surgical intervention is used. Experienced orthopedic doctors perform surgeries to change the deformation of a child’s chest. In a percentage of cases, a positive outcome of the operation is achieved.

The rehabilitation period should be as productive as possible, since the future of the baby depends on it. Therefore, it must be carried out with great benefit for the child's body.

Source: rib cage!

Did you give urine according to Sulkovich?

It’s amazing, I only found out about this test here:((. We were prescribed only blood and it turned out to be normal.

we are seven months old, we have the same problem, our pediatrician told me to take Kidipharmaton and take vitamin D, and said that in our city all the babies have primary rickets, I am not satisfied with this answer, I want to see another doctor, but he is still on vacation .

Eh, I don’t even know what to advise. My rickets was diagnosed at 3 months, but also uncertainly, and at 1.5 my legs became X-m. and the ribs are slightly turned out, but this is almost unnoticeable and seems to go away. And we focus on our feet in treatment. But pine-salt baths won’t hurt you either. Exercise yourself and your child every day. They showed me like a massage therapist how to smooth out the ribs so they would fall into place. So we take calcium in courses, vitamin D 2-3 drops (but right now in the summer I don’t give it).

Look, maybe you have some orthopedics institute. In St. Petersburg, for example, we have the Turner Institute, where they treat seriously ill children and you can come for a consultation for a fee. And don’t panic too much, everything can be fixed, right now every 2nd person is diagnosed with rickets and all the deformities grow over time. No one frightened us that 2 years would come and it would be fucked up, then everything would be useless. For example, then you can do exercise therapy with them, but after 3 years, it still doesn’t work out.

I had the same situation when I was one year old (but the child has lactose intolerance, so calcium was not absorbed from milk in the required amount). Now my son is 4 years old and it’s okay, we massage and strengthen the muscles of the back and arms, do extension exercises and watch his posture. There is no question of any surgical intervention, now this is already such a feature of the structure of the chest!

Tell me how you solved the problem?

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Source: Komarovsky funnel-shaped deformation

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but they say that it doesn’t fall into the same funnel twice. SP: get-togethers

It’s just cruel, 10 years ago my eldest stuck a cucumber in her nose before New Year’s Eve, I didn’t think that 10 years later I would be standing to dry out pieces of them in my youngest’s nostrils. Well, why are children so interested in sticking something up their nose? no, I don't understand.

Apparently for prevention :)

I’m reading Dr. Komarovsky. Child from birth to one year

His famous book “Child Health and common sense his relatives." When my daughter was a baby, reading this book, I was choking with indignation (especially when it came to being carried and fed). Now, I’m probably not such a anxious mother anymore, because I read this author with pleasure :) However, in some places I still smile. Tell me, is it true that there are children who sleep on the balcony from 7 am to 10 pm with breaks only for food? True, there are those who after gymnastics.

That’s when I relaxed)) With the third one, life experience saved me)))

Chest deformity. Pediatric medicine

My daughter has a chest deformity (keeled chest) stage 1. The doctors we show up to don't think so serious illness, because “There is no harm to the body, but appearance- Well. “Of course, this doesn’t suit me, but I don’t know what to do. Maybe you can tell me something? Just please don’t write that “breasts will grow and nothing will be noticeable” - this is true, but I would prefer to do something now. We get massages regularly, and that's all for now.

Diving according to Komarovsky. Child from birth to one year

Mommies, who has experience in teaching babies to dive in a large bathtub? I understand that our third time means nothing, but so far there is no progress. The child swallows water, then screams, and for a minute he comes to his senses - I feel sorry for him! He probably thinks: “My parents are idiots.” :) Although today I held my breath twice. Share your experience in this area and impressions, it’s very helpful!

Meso and biorevitalization?. Fashion and beauty

Girls, let's share our experience. What did you inject, what are your impressions and recommendations? My experience: 1) meso cocktails (with hyaluronic acid, vitamin C, etc.) - my complexion became fresher during the course, I think it’s just a reaction to an injury and that’s all. I didn't notice anything else. 2) Princess Rich - nothing at all, wasted money. Now I'm confused. After winter, my complexion is sallow, dehydrated, my forehead is a little wrinkled. Something definitely needs to be injected. but here's the thing. Hyalreper and Hyaluform are recommended by a cosmetologist.

Well what can I say. It's very affordable. The effect is not comparable to the cost, well, personally, this happened to me :)

More details about each type:

Meso is a waste of money if you are not 25 years old. I’m 37 and there was no effect. Then I went and read it on the Internet, it turns out that everyone has known this for a long time, except me: (In the reviews, everyone says not to even spend money. For those who have the effect, it goes away in a week.

Bio - I didn’t see any improvement specifically (the task was to moisturize my very dehydrated skin). I did 3 procedures in a row (first 1 IAL, then a stronger one - three Hydrate procedures).

My impressions are that for a week (up to 10 days) after each procedure I looked “beautiful”, the marks from the injections became inflamed in places because I had to use foundation to disguise it, I always looked like I had acne. Only the pain went away and the face cleared up - and now it’s time for a new procedure and so on in a circle :(

Either my case is advanced, or I don’t know what.

Funnel specialists. deformation?. Pediatric medicine.

Where in Moscow good specialists by funnel chest deformation in a child?

Komarovsky about the situation. Society

stole from a friend *** Topic moved from the conference “SP: get-togethers”

Perhaps I am not aware, I would be grateful for links

Tell me about sumamed(((. Children's medicine

Please, dear moderators, do not delete. Girls, tell me about sumamed. why did the doctor prescribe it with suprastin. and now in order. My boy has had a high fever since Thursday, snot, and a sore throat, today the doctor visited and prescribed him to take 1 TB of sumamed. per day after meals, and suprasin 0.5 TB. 2 times a day. I can’t understand why not some kind of gastric? (Linex, baktisubtil, bifidum bacterin, amoxiclav) and, in principle, why is sumamed dangerous? Thank you all very much)

who treated giardiasis? Child from 1 to 3

Girls, help, who treated Giardia? Share your experience. The doctor prescribed Macmiror, an antibiotic, for 2 years. I know that trihapol is also prescribed. And we already suffer from constipation, I’m afraid that antibiotics will later require treating the dysbacteriosis. Maybe there is another way? and then these lamblia are everywhere: WATER, SAND, DIRTY HANDS. Now we’ll treat it, but for how long? and then what about the antibiotic again?

In principle, Macmiror is not an antibiotic, but I have long ago sworn off giving my children drugs in such dubious cases, even if they (the children) are clearly feeling well.

Prevenar or pneumo, who knows about them? anti-vaxxers.

Before kindergarten I decided to take Prevenar 13, they were already booked for August 1st in pediatrics. recommended there, with the wording - it protects well against colds. A friend’s daughter was very sick in the garden, they stayed at home, got vaccinated, and for half a year the small sniffles calmly went away. other acquaintances are served in the medical center and today they asked their pediatrician, she recommends pneumatic 23, which is more suitable for kindergarten. I poked my head into the description in the prevenar of 7 serotypes, in the pneumo there are 23 serotypes, so I understand how.

Pulmicort?. Pediatric medicine

The child was examined by two doctors (one yesterday, the other today). diagnosis of acute obstructive bronchitis. One from the Filatov hospital says: “get rid of berodual and pulmicort, these are hormones, you don’t need them.” The second (the main one, a pediatrician from a paid clinic), on the contrary, says: “leave pulmicort, I directly insist, because it relieves replenishment well.” The rest of the appointments are practically match. I don't know what I'll lean towards. Two months ago we were in the hospital (obstructive bronchitis and incipient...

There are so many doctors, so many opinions, but the child is yours, and only you are responsible for his health.

How to overcome clubfoot. Orthopedic problems in children

As a rule, in the presence of clubfoot, the muscles develop incorrectly, asymmetrically, and unevenly. Some muscles are overstrained and tight, they need to be relaxed (by the way, a lot of problems can go away as a result: headaches, bad dream etc.), and poorly developed muscles need to be pumped up, trained, and made to work correctly. At 7–15 years of age, the body still continues to grow, the bones and joints are formed, and deformations and curvatures occur where there is no muscle resistance or they contract unevenly. When walking, clubfooted children often not only place their feet incorrectly, but also make an incorrect movement of the leg from the hip. As a result, the knee “looks” to the inside, and it seems that when walking, the legs “stick”. Remember that clubfoot, flat feet, scoliosis are all links in one chain. What to do? You saw the problem and understood.

Convert a dry cough to a wet one. Pediatric medicine

Girls, please recommend a remedy that helps transform a dry, boring cough into a wet one. Just don’t send me to the doctor. There were two today. STUPID. One diagnosed with ARVI, the other with the flu. Both gave completely different medications. The child has a very dry cough frequent cough. What to do? Take the child to the sanatorium on Thursday.

1. drinking plenty of fluids- MANDATORY, frequent fractional.

2. irritants - sour, sweet, salty, every half hour or hour. maybe a drop of lemon, a small piece of candy, a lick of a pickled cucumber.

after 3-4 days everything returns to normal and the cough gets better.

School of Doctor Komarovsky. Early development. 03/11/2012

Where to find a good orthopedist. Pediatric medicine

My daughter has problems with gait and posture. Where to go? Orthopedist, physical education clinic? slender, young, and walks like a bear. I'll be 16 soon. I'm worried. *** Topic moved from the conference “SP: Gatherings”

The child often sighs and yawns - what is this? Pediatric medicine

Good afternoon About a couple of months ago, I noticed that the child (8 years old) began to breathe frequently and deeply, about once every minute or two, and also yawns often, although he was getting enough sleep. He himself explained to me that it was as if he couldn’t breathe completely, like there was some kind of barrier. This is not shortness of breath or difficulty breathing, that is, clearly not of a respiratory nature - when he sleeps, everything is perfect. Very active, he can handle two hour-long workouts (taekwondo, football) in a row just fine. Appetite, everything else - in.

Urgently! Alternating antipyretics? Child from 1 to 3

What is alternated when high temperature? Paracetamol doesn't knock it down. Should I try Nurofen?

Regarding rubbing with vodka. I am not a supporter of such methods. And just in case, keep in mind that this should absolutely not be done if your extremities are cold.

What's the temperature?

If you’re under 40 and don’t get confused, then you can add no-shpu + suprastin (or another antihistamine) to Nurofen and wrap your legs.

Why is there clear snot when teething?

Dr. Komarovsky, in his daily five-minute segment in the morning program, answered another question about snot during teething. This is what he said: Indeed, that which decreases during eruption local immunity and the risk of catching a viral infection increases, given the decrease in the influence of mother's milk after 6 months of age as a supplier of antibodies. But there is a transparent snot and other explanation - the fact is that the aorta passing through oral cavity also passes through the nose.

At an appointment with a neurologist: a few words about normality and pathology.

Examination of the child by a neurologist at 1 month

About crooked legs

Another well-known manifestation of rickets is X-shaped or O-shaped curvature of the legs. Less known, but much more dangerous deformities pelvic bones in girls, which may subsequently cause serious problems at the time of delivery. Vitamin D deficiency in a child’s body occurs as a result of insufficient intake of this vitamin from food, or due to insufficient sun exposure of the baby’s skin, and most often as a combination of these two reasons. Deficiency of solar rays in the ultraviolet spectrum for such, in volume.

And the tireless promotion of exclusive breastfeeding of children (if it is effective, of course :) leads to the fact that our pediatricians will increasingly encounter cases of “terry” rickets. Unless, of course, those same pediatricians take action active actions for the prevention of rickets in breastfed children. By the way, colleagues of our children's doctors from the USA and Britain have already encountered this problem. The point is that human milk contains very little vitamin D - only IU (international units) in 1 liter. A child’s daily need for this vitamin is about 400 IU. As studies show, in major cities In northern latitudes, due to atmospheric pollution, a minimum amount of sun reaches the earth's surface.

I am now 23 years old.

I have chicken breasts.

And I'm embarrassed about it.

Is it possible to be cured?

And isn’t this disease dangerous, how is it dangerous for me now?

Our guest is Evgeniy Olegovich Komarovsky.

I never allow myself to criticize my colleagues, I try to treat any child as I would treat my own, but I am forced to cancel some previously prescribed medications and make other diagnoses (mostly correct). If it’s done by a certain professor, that’s understandable, but if it’s not a professor, then it’s understandable. And if a certain doctor unsuccessfully treats with hormones bronchial asthma, and then at an appointment with Komarovsky it turns out that it is not asthma, but whooping cough, then the doctor is not at all happy that someone turned out to be more attentive and more professional. Moreover, this does not cause a desire to improve one’s own qualifications, but negativism towards the disgusting “very smart” Komarovsky. There's nothing you can do about it. Yes, I'm not trying to do anything. I’m not bored, there are enough patients, the treatment results seem to be quite good, so why complain? We only respect real power, the real ones.

Pacifier and breastfeeding: my pros and cons

Some pediatricians advised using a pacifier in order to exclude such bad habit, like sucking fingers and clothes, others, on the contrary, warned that sucking a pacifier can lead to malocclusion and a decrease in lactation in the mother. By the time my first son was born, I still hadn’t decided which “school” I should follow, and just in case, I stocked up on several pacifiers from different brands (cherry-shaped, teardrop-shaped, and orthodontic with a beveled top). The baby was born, and while still in the maternity hospital, I noticed how strong the intrauterine habit of thumb sucking was. Rec.

My mother gave a pacifier to her child for the first time because... I was afraid to be alone with him without this “weapon” when I simply needed to take care of my health after giving birth. It's ALWAYS GOOD if a child takes a pacifier, the main thing is that he knows how to take it - you never know when it will come in handy. And to give or not to give is your right.

I was luckier, I first of all used the seventh tip - intuition.

Children's heart. Childhood diseases

Treatment with maternal love. Psychology and education.

Psychotherapist B.Z. Drapkin offers a unique method of treating neurosis, enuresis, stuttering, vegetative-vascular dystonia and other ailments in children.

Hydrocephalus: don't miss the time! Health of a child up to one year

Signs of hydrocephalus in newborns, treatment of a child with hydrocephalus

Scary doctor. Why are children afraid of doctors? Children's health

Help the doctor be good!

“The doctor is simply obliged to examine the oral cavity for any illness, and he will do this regardless of whether Masha wants to open her mouth or not. In the latter case it will be painful and unpleasant.” I completely agree with Ptichka - this is SADISM. Good doctor will be able to make Masha open her mouth herself, and will examine her in such a way that Masha will not want to leave the office.. There are even sisters who manage to draw blood from children in such a way (light hand + jokes) that the children do not cry( I know cases).. And excuses about the fact that it is impossible to take it painlessly are simply a sign of ignorance, or, even worse, unprofessionalism.

Grandmother: a social phenomenon through the eyes of a pediatrician.

It is simply pointless to deny the enormous role of grandmothers in raising the younger generation.

Cephalohematoma: everything can be fixed! Newborn

In this case, a certain amount of bilirubin (a product of the breakdown of hemoglobin in tissues) will enter the bloodstream and the child may develop jaundice, which will last longer than physiological (transient jaundice of newborns) and will not disappear by the 10th day of life. In these cases, the periosteum in the area of the cephalohematoma becomes denser, the hematoma ossifies, that is, it ossifies with subsequent bone growth, which leads to deformation or asymmetry of the skull. Under the cephalohematoma, a bone fracture is sometimes found, through which communication with the epidural hematoma is possible. Diagnosis of cephalohematoma is usually not difficult. Ultrasound examination can help to clarify the extent of cephalohematoma, as well as to exclude the presence of a bone defect and cerebral hernia.

Doctor, I have it. About illnesses

Finally, he frees the half-strangled victim and shakes his head with concern. - Yes, my dear, this is a serious case! - and turns to the assistant, - Andryusha, an injection of “magnesia.” To the head. In life you often hear: a doctor is rude, inattentive, never listens to the end, interrupts, pretends to be God knows what. We have to admit: yes, in our medical universities they don’t teach good manners, where would it fit into the program. However, firstly, good manners are not a guarantee against conflicts: politeness without attention to the patient sets one even more against the doctor. And secondly, according to some observations, it is very often a source of conflict between doctor and patient.

Notes from a young mother. Part I. Shopping for a newborn

Having a little experience (my daughter is 3 years old) and having read magazines and all sorts of books, I made a rough list of what might be useful, and began interviewing friends who had recently given birth about what they actually found useful and what they could do without. .

Heart secrets. Heart defects in children. First visit to the doctor

To be sure of the baby’s health, parents can do this test without a referral, for a fee at medical center. What may alert the doctor and parents? Heart murmur. It is detected by the doctor by listening to the baby's heart. Echocardiography is mandatory in this case. Murmurs can be organic, which are associated with heart disease, and inorganic, or functional. Functional murmurs in children are normal. As a rule, they are associated with the growth of the chambers and vessels of the heart, as well as the presence of an additional chord or trabecula in the cavity of the left ventricle (heart chamber). The notochord or trabecula is a cord that stretches from one wall of the ventricle to the other; a turbulent blood flow is created around it, trace.

No teeth at 11 months. Pediatric medicine

This is fine? At birth, the child was diagnosed with hydrocephalus, but the child is developing normally. Sits, stands, tries to speak. But there are no teeth yet. Or should we already sound the alarm? P.S. The child is not mine, but a very close friend’s.

Movement impairment syndrome. Other children

Hello, I'm not from this conference, but I have a question. somehow there is no answer. Movement disorder syndrome in a child. The child is 2 months old. What is this all about and what does it threaten in the most extreme cases? Thanks in advance for your answers!

Movement disorder syndrome in children under one year of age is a collective name for muscle tone disorders. Varieties are possible: muscle hypotonia syndrome - weak tone, muscle hypertension - increased tone, muscular dystonia- different tone in different limbs (where it is increased, where it is decreased).

Nowadays, EVERYONE is diagnosed with muscular dystonia syndrome, sorry. There is even such a joke - “if there is no SMD in your child’s chart in the first year, then you simply forgot to visit a neurologist” :)

So if the neurologist does not sound the alarm, but simply prescribes a planned course of general massage, then this is the NORMAL. Violations of tone will pass by a year and a half.

For mothers of restless children: PEP - myths and reality.

Girls, we were diagnosed with para-whooping cough. Cough. Other children

Girls, we were diagnosed with para-whooping cough. We have been coughing for 2 weeks now. But now I’m also vomiting. We started taking an antibiotic. Help anyone as much as you can. Who suffered from this? With our neurology, all we needed was whooping cough. And he could vomit if he choked.

Now your task is to reduce the number of paroxysms to a minimum, notice what causes seizures and avoid these situations. Limit all types of activity (if possible), avoid bright lights and loud sounds. The room in which the child is in should be quiet, even during the day you can curtain the windows, disturb the child as little as possible, prevent outbursts of anger in him, you can even give up educational principles for this time and follow the child’s lead completely, just to make him less nervous. Feed and drink in very small portions, but more often, no irritating foods.

I don’t want to upset you, but complications occur mainly in the respiratory system and the brain. But I want to please you, complications mainly occur in infants(up to a year). I don’t want to scare anyone, I personally haven’t yet vaccinated my child against whooping cough (we had contraindications and we got it after a year), I haven’t gone anywhere with the child. There are no vaccinations against parapertussis, but after a year it is no longer so dangerous.

Every paroxysm is brain hypoxia (to one degree or another), even children “without neurology” can develop convulsions - often in infants, rarely in older ones. I ask you again, do not be alarmed, if you are older, these complications occur mainly in infants, but after severe paroxysms, hemorrhage may develop in the brain, eyes, skin and mucous membranes. I will not further describe all the horrors and what complications there are from the respiratory tract, but you should clearly understand what your efforts should be aimed at - reducing the frequency of paroxysms. In my opinion, you made all the appointments correctly, but you still need to consult with the treating neurologist, maybe he can tell you something.

Hang in there and get better quickly, your recovery stage will soon begin and it will be easier, paroxysms will still remain, but they will no longer end with vomiting. Get well!

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Chest deformity in children is a pathological condition with changes in the shape of bone and cartilaginous structures. This type of pathology occurs in 2% of newborns. In infants it is hardly noticeable, but by the age of three the developmental anomaly becomes pronounced.

The rib cage is a musculoskeletal frame located in the upper half of the body. It serves to protect the heart, lungs, and blood vessels. With an anomaly, the cartilage of the costal arches with the sternum is deformed.

In congenital pathology, the defect develops at the embryonic level: the right and left rudimentary cartilages of the sternum are incorrectly connected or between their upper and lower section There is a flaw in the form of a cleft. The cleft may be so large that there is a risk of pericardial protrusion with congenital heart defects.

WITH birth defects About 4% of newborns are born in the thoracic bone structures. Bone and cartilaginous defects reduce the protective and frame function, a pronounced cosmetic defect causes psychological disorders in kids. Deformation of the chest in children is accompanied by a disorder of the circulatory system, and children with this pathology are excessively asthenic and physically lag significantly behind healthy peers.

Based on the degree of change in structures, the child’s condition is assessed as:

compensated;
subcompensated;
decompensated.

The degree of compensation depends on the characteristics of the body, the growth rate of bone structures, the degree of stress, and other existing diseases.

Localization of changes in bone structures occurs:

along the front surface;
on the back surface;
along the side surface.

If a child is born with dysplastic (congenital) anomalies, then acquired causes of pathology with deformation can develop against the background of chronic pulmonary diseases, tuberculosis, rickets, scoliosis, injuries, burns.

A congenital malformation is associated with underdevelopment of a whole complex of structures: the spine, ribs, sternum, shoulder blades, and muscles in the chest. The most severe anomalies of bone structures appear on the anterior surface of the chest - these are funnel-shaped, flat, keeled deformities of the chest in children.

Congenital pectus excavatum deformity (CFD) is also called “cobbler's chest.” With this congenital pathology, the costal cartilages are so defective that they create a depression along the middle and lower third of the chest. This congenital anomaly ranks first in number - about 90% of cases.

External signs by which funnel-shaped deforming pathology is determined:

the chest has a shape with expansion in the transverse direction;
signs of kyphosis with lateral curvatures.

As the child grows older, this type of deformation becomes more pronounced.

The rib bones grow and push the sternum inward. The sternum becomes concave and shifts into left side and unfolds the heart along with large vessels.

This type of defect results in a decrease in the volume of the chest cavity.

A curved spine and an irregularly sunken chest shape displace the heart and lungs.

Arterial and venous pressure changes. Children with pectus excavatum suffer from multiple developmental defects, often due to a strong family history.

Symptoms that develop against the background of this type of deformation:

retardation in physical development;
autonomic disorders;
chronic colds.

Typically, by the age of three years of a child’s life, the degree of deformation reaches its peak and subsequently becomes fixed.

There are 3 degrees of severity according to displacement:

with the first, the displacement depth is about 2 cm;
on the second - about 4 cm;
on the third - more than 4 cm.

A keeled abnormality is called “chicken breast.” This is a deformity where the sternum is convex and protrudes forward. The anteroposterior dimensions are increased.

The keeled anomaly occurs due to overgrown costal cartilages of the fifth to seventh rib. The sternum protrudes forward, the angles of the costal arches are at an acute angle in relation to it (keel-shaped). Most often, this form of anomaly is congenital, but there are cases of complicated forms of rickets and bone tuberculosis.

Keel-shaped growth is observed in children from 3 to 5 years of age. With growth, the deformation becomes more noticeable. The heart changes. This is the so-called “hanging heart” syndrome. IN in rare cases the keeled anomaly is accompanied by pathology of the pulmonary and cardiac structures. In children, this is most often a cosmetic defect, and doctors do not observe any abnormalities. TO adolescence and older, a carinatum of the chest can provoke functional disorders associated with a significant decrease in lung volume. The oxygen consumption rate is significantly reduced. Patients with keeled chest deformity experience shortness of breath. They complain of fatigue and palpitations after minor physical exertion.

Surgical correction is prescribed only when the doctor objectively determines that there are disturbances in the functioning of the internal organs.

A flat chest is considered a body feature. In this case, the anteroposterior dimensions of the chest are reduced, but there are no disturbances in the functioning of the internal organs. This option does not count pathological condition, and therapy is not indicated here.

TO congenital deformities also include convex sternum, congenital cleft sternum, Poland syndrome.

Curved sternum (Currarino-Silverman syndrome) is the most rare type of deformation of the thoracic bone structures. It is a protruding groove along the upper third of the chest: the ossified sternum with overgrown cartilages of the right and left costal arches form a groove. With this type of deformity, the remaining areas of the thoracic bone structures look normal.

This deformity does not pose a threat to the patient's health and is only a cosmetic drawback.

A congenital cleft sternum is an anomaly in which the sternum is completely or partially split. It is considered a serious and dangerous developmental defect. In addition to a cosmetic defect, the depression on the front surface of the chest does not protect the heart with its great vessels. The respiratory excursion of the chest with such a congenital defect lags behind the age norm by 4 times. Decompensation from the cardiovascular and respiratory systems increases over a short period of time.

Surgery is indicated to correct congenital cleft chest.

The specialist determines the diagnostic picture of the development of deformity by external signs. As instrumental diagnostic methods X-ray and MRI are connected.

MRI is used to detect bone defects, the degree of lung compression, and mediastinal displacement. The study also makes it possible to identify pathology of soft tissues and bone structures.

If the doctor suspects that the functioning of the cardiovascular and pulmonary systems is impaired, he prescribes echocardiography, monitoring heart rate according to the Holter method and an x-ray of the lungs.

Deformation of the chest in children using conservative methods of therapy (medicines, massage, physical therapy) is not treated.

If the defect is minor and there are no significant cardiorespiratory dysfunctions, the child is observed at home.

If there is a second or third degree of displacement, surgical reconstruction is indicated. Typically, young patients are operated on at the age of 6-7 years. Correction method using surgical intervention a lot, but a positive effect from surgical correction is achieved only in half of the children.

Each operation is performed in order to increase the volume of the chest and straighten the curved spinal column. Afterwards, supportive treatment is prescribed: massage courses, corrective exercises, wearing orthopedic corsets.

Additional sources:

1. Kosinskaya N.S. Developmental disorders of the osteoarticular apparatus. Section: Orthopedics and traumatology www.MEDLITER.ru electronic medical books

2. Bukup K. Clinical study bones, joints and muscles. Section: Orthopedics and traumatology www.MEDLITER.ru electronic medical books

Over the course of a person's life, their bones change greatly. This is especially noticeable in the chest: in a baby it looks completely different than in an adult. Moreover, not only the configuration of this part of the skeleton is different. The ribs and sternum of a newborn baby, unlike similar bones of older children and adults, are largely composed of cartilage tissue. This explains the high likelihood of chest deformities in children.

Specifics of the structure of the chest in children

When a baby is born, its chest has a barrel or cone shape. The ribs are located almost horizontally and are attached perpendicular to the spine. At the same time bone tissue Only the middle part of each rib is folded: the ends located closer to the sternum and spine, as well as the sternum itself, are made of cartilage.

At about one year of age, the shape of the chest in children begins to change. The sternum drops slightly, the ribs take on an inclined position, the diaphragm and organs abdominal cavity move down. At the same time, the bones actively strengthen and grow. Gradually, the chest becomes flatter in the anteroposterior direction (oval in cross section). The period of rapid growth of the upper part of the skeleton in girls begins at 11, and in boys at 12 years. By the age of 18, a person’s chest is considered fully formed.

The structural features of the baby’s skeleton affect the functioning of the lungs and heart. An X-ray of the child's chest shows that the ribs are constantly in a position characteristic of inhalation. This is why the mobility of the chest bones in children is much less than in adults. Light crumbs in the first year of life increase mainly downwards. Babies breathe diaphragmatically and very frequently. This feature, combined with the relative weakness of the pectoral muscles, often causes increased susceptibility of young children to colds and the severe course of such ailments.

Pathologies of chest development in children

Chest deformities in children can be congenital or acquired. As a rule, the former have genetic causes, and the occurrence of the latter is a consequence of diseases (bone tuberculosis, rickets, scoliosis, chronic respiratory diseases). The most common deformities of the thoracic skeleton are:

Funnel-shaped (the sternum and adjacent parts of the ribs are pressed inward);
Keeled (the sternum protrudes; the ribs join it perpendicularly);
Flat chest;
Cleft sternum;
Barrel-shaped chest;
Scaphoid chest.

Boys suffer from congenital forms of chest deformation approximately 4 times more often than girls, and pathologies of this type take on more pronounced forms in them. Almost all such bone lesions intensify with age: often at 2-3 years of age, funnel chest can be seen only on an X-ray of the child’s chest, but by the age of 6-7 years the defect already becomes obvious.

Deformations of the breast bones negatively affect the functioning of the lungs and heart. Children suffering from such lesions are, as a rule, physically much weaker than their peers; they are very susceptible to seasonal colds, have psychological problems, sometimes they lag behind in intellectual development. Fortunately, such ailments can be successfully treated. Therefore, parents, having noticed such deviations in their baby, should immediately contact specialists and not be afraid to follow their advice regarding the surgical method of treatment, since this method is today the most effective in correcting deviations in the development of the chest in children.

The rib cage is the musculoskeletal frame of the upper body, the main purpose of which is to protect the internal organs. Chest deformity refers to congenital or acquired changes in the shape of the chest. They affect the development and full functioning of the chest organs (cardiovascular and respiratory systems).

Classification and types

Chest deformities are usually divided into the following types:

Funnel-shaped deformity is characterized by the fact that the chest is as if depressed, sunken inward. It is also called “shoemaker's breast”;
Keeled - the sternum protrudes forward, like the keel of a boat. Another name is “chicken breast”.
Flat chest - the sternocostal complex is flattened in the anteroposterior direction.
There are also such extremely rare species deformations like:
Congenital cleft sternum - in this congenital malformation, the patient's chest is cleft;
Costomuscular defect - this deformity affects not only the chest, but also the spine, muscles and other organs (Poland syndrome);
Arched chest - very rare (Currarino-Silverman syndrome).

The severity of chest deformation can vary: from a minimal cosmetic defect to a pronounced pathology.

Based on the location of the deformation, it is customary to distinguish between anterior, posterior and deformations of the lateral walls of the chest.

Based on the method of occurrence, chest deformities are divided into congenital and acquired.

Causes of deformities

Most chest deformities in children are a genetic pathology. In other words, the genes already have a program that launches abnormal height and development of thoracic cartilage. Quite often, parents tend to blame themselves for the appearance of any deformities in their baby. But, for the most part, chest deformation is a genetic congenital defect, which, fortunately, can be corrected.

If the deformity is congenital, then in such situations the shape of the anterior part of the chest is changed. Such disorders are accompanied by underdevelopment of the ribs or their absence, underdevelopment of the muscles and sternum.

The causes of acquired deformities include various diseases (rickets, scoliosis, chronic lung diseases, bone tuberculosis), injuries, burns that occur in the chest area.

When the formation of bone structures is disrupted, the most severe forms deformations.

Funnel chest deformity

The most common defect of the chest wall is its funnel-shaped shape. Moreover, it occurs much more often in boys than in girls. The anterior sections of the ribs, costal cartilages, and sternum are sunken. Since this pathology was often observed in family history, the main cause of its occurrence is considered to be genetically determined by changes in the normal structure of connective tissue and cartilage.

With this defect, the volume of the chest cavity is reduced. With pronounced forms of funnel-shaped deformity, curvature of the spine, changes in venous and blood pressure, disruption of the functioning of the lungs and heart, and displacement of the heart are observed.

In traumatology, funnel-shaped deformities are divided into three degrees:

I degree. The heart is not displaced. The depth of the funnel is a maximum of 2 centimeters.
II degree. The heart moves up to 3 centimeters. The depth of the funnel is about 2-4 centimeters.
III degree. Displacement of the heart by more than 3 centimeters. The depth of the funnel is from 4 centimeters or more.

The younger the child, the less noticeable the deformation. According to the so-called paradox of inhalation, it is during inhalation that the retraction of the sternum and ribs intensifies. As the child approaches the age of three, the pathology begins to take on more pronounced forms. Children with this problem suffer from frequent autonomic disorders, are lagging behind in physical development, and have weakened immunity.

Subsequently breathing excursions the chest is reduced by three to four times compared to the norm. Thoracic kyphosis and scoliosis begin to develop. The deformation becomes fixed. The depth of the funnel gradually increases. Disturbances in the development of the respiratory system and cardiovascular system are increasingly occurring.

Pileated chest deformity

The main cause of keeled chest deformity is excessive growth of costal cartilages (mainly cartilages of ribs 5-7). The sternum protrudes forward and gives the baby's chest a keel shape. The pathology becomes more pronounced with age.

Gradually, the cosmetic defect becomes more and more noticeable. But this type of pathology practically does not affect the spine and internal organs. The heart takes the shape of a drop. The child may complain of fatigue, rapid heartbeat, and shortness of breath.

Flat chest

The sternocostal complex is flattened in the anteroposterior direction. Children with this pathology have an asthenic body structure (narrow shoulders, tall stature, long limbs). There are also disproportions between body weight and height. Children with this pathology lag behind their peers in physical development and are prone to frequent colds.

Cleft breast

Clefts can be complete or partial. They occur during intrauterine development of the fetus. As the child grows, the gap in the sternum area increases. This pathology is very dangerous because the anterior part of the heart and major large vessels are not protected by the sternum, but are located directly under the skin. In this area, you can visually determine the pulsation of the heart.

Patients with cleft breasts require urgent surgical intervention. Delaying surgery may result in delayed physical development. You should also take into account the high probability of injury to the child’s internal organs.

Acquired chest deformities

Acquired chest deformities are very diverse. This diversity is directly proportional to the causes that caused them. For example, the cause of the development of emphysematous chest is chronic pulmonary emphysema. The sternum becomes barrel-shaped, the ribs are positioned horizontally, the intercostal spaces are widened, and the anterior part of the chest is enlarged. The child may have impaired mobility of the diaphragm, problems with heart function, and weakened breathing.

The consequences of chronic diseases of the pleura, as well as the lungs, with the growth of fibrous tissue in them (contributes to a decrease in the overall mass and shrinkage of the lungs) can be the development of a paralytic chest. With this pathology, the lateral and anteroposterior dimensions of the chest decrease, the shoulder blades protrude sharply, and the intercostal spaces widen. During breathing, asynchronous movement of the shoulder blades occurs.

A scaphoid chest develops in children suffering from syringomyelia (a disease nervous system, in which motor functions and sensitivity are impaired). In children with this deformity on the upper and middle parts a scaphoid depression appears in the sternum.

The consequences of severe curvature of the spine is the development of a kyphoscoliotic chest. This deformation causes severe disturbances in the functioning of the lungs and heart and is difficult to treat.

Diagnostics

It is possible to diagnose chest deformation even by external signs.
One of the instrumental research methods is radiography, which allows one to evaluate the shape and degree of deformation. Computed tomography of the chest determines bone defects, the degree of deformation, the presence of compression of the lung, and the presence of mediastinal displacement. Magnetic resonance imaging is performed to obtain more information about bone and soft tissues.
Diagnosis of the functioning of the heart and lungs caused by chest deformation requires comprehensive survey: echocardiography, pulmonary radiography, cardiac Holter monitoring, etc.

Prevention

The best way to avoid acquired forms of chest deformity is timely treatment of lung diseases.

Try to teach your child to play sports from an early age, to exercise the upper and lower abs; this will strengthen the spinal muscles, tighten them, and also reduce the risk of chest curvature.

Treatment of chest deformity

Treatment depends on the degree of deformation, the presence of functional disorders of the heart and respiratory system. For minor deformities (funnel-shaped or keeled), you can get by with conservative treatment methods, such as massage, exercise therapy, wearing corsets, swimming, breathing exercises, and physiotherapy. And if the child already has II or III degree of deformity, then conservative treatment It cannot correct the defects; it can only stop the progression and maintain the functionality of the chest organs. At these stages, as a rule, doctors recommend surgical treatment.

If the deformity is congenital funnel-shaped, then at the initial stage of treatment it is possible to use the vacuum bell method. Its essence is to create a vacuum over the funnel, which will pull the funnel out. But in situations where this method is not effective, sternochondroplasty may be prescribed. The age of 6-7 years is considered the most optimal for this operation.

The stendrochondroplasty method is carried out in this way: transverse incisions are made on the chest, the pectoral muscles are separated, the costal cartilages are excised and a reduction plate is inserted. The method is effective, but the scars that remain on the chest significantly reduce the aesthetic result.

Another method of surgical intervention is minimally invasive surgery using the Nuss method. It leaves no rough scars. Metal plates are installed in the incisions on the sides, the purpose of which is to straighten the sternum and permanently fix it in correct position. Such plates are installed for a child for 3-4 years, after which they are removed. During this time, the chest takes on the correct shape.

In a case of carinatum deformity surgical treatment depends on the presence of functional disorders and the severity of the defect. And yet, in early age Wearing a corset is considered effective, which often eliminates surgical interventions in the future.

Flat chest childhood It is best to correct it with therapeutic and respiratory gymnastics, swimming in the pool, etc. But the cosmetic defect will remain, which in the future can become the cause of physical inferiority complexes.

Mandatory surgical intervention requires a cleft chest. The type of surgery depends on the age of the child. Up to one year - after excision of the sternum midline sutured, since the bones at this age are flexible, they can “connect” with each other. After a year, rib autografts fill the discrepancies between the segments of the sternum (through partial excision), and a titanium plate is installed behind the sternum.

Surgery is a very effective treatment method, 90-95% of children get a positive result, and only one in thirty children may sometimes require a second operation.

Parents most often notice chest deformities in teenage children by accident: suddenly it turns out that bones begin to “bulge” in the center of the child’s chest, or vice versa - a depression appears. Such deformations are caused by the growth of cartilage tissue, or various curvatures of the sternum and anterior ribs. We learned how to deal with the problem.

Common diagnosis among adolescents

In January, Nikolai Alekseev turned 13 years old. Traditionally, the birthday was celebrated in the water park. We swam in the pools, rode the slides and, of course, took a lot of photos. And in April, in honor of the birthday of the head of the family, they decided to repeat the water holiday. It was there that Nikolai’s mother, Lyudmila, first noticed that her son’s chest looked somehow strange. “I didn’t know then what it was, how dangerous it was and what to do about it. My mood deteriorated, but I controlled myself and constantly mentally reminded myself that nothing bad had happened yet, the child was cheerful and cheerful, and we hadn’t been to the doctor yet. At home, I looked through the photos from my January birthday again and made sure that nothing was noticeable in them. But the very fact that an incomprehensible “thing” appeared in the child’s chest within 3 months did not add optimism, so we did not postpone the visit to the doctor and two days later we went to see an orthopedist in private clinic. There they heard the diagnosis - “keeled chest deformity.” They didn’t intimidate us, they offered to solve the problem special exercises. However, the doctor did not give any guarantees - only a slight hope that a good result was possible. The price of the issue is not a joke, so I started studying articles on the Internet, where I came across conflicting information: some advocate for a special corset, others for exercises, and still others for surgery. It’s very difficult to figure out which of everything written is “mother’s” speculation and which should be trusted.”

Who's unlucky

Most often, thin boys and men turn to doctors with chest deformities. It turns out that this problem will not affect girls and chubby boys? Unfortunately, this is not the case, and there are no gender preferences for deformation, it’s just that in girls it is disguised behind breasts, and in large boys it is hidden behind a layer of excess fat. According to experts, girls suffer from breast deformation three times less often than boys.

What a misfortune

Typically, deformities occur during active periods of growth: 5-8 and 11-15 years. It is impossible to predict in advance who will be unlucky and when, since the causes of the disease have not yet been studied. According to one theory, it is believed that in 25% of cases the cause may be a genetic predisposition, and the “source” is not only mom and dad, but also grandparents. There is another opinion. In the fetus, the chest is formed at 6-10 weeks of pregnancy, and if during this period the mother suffered an illness, stress, or even drank something wrong (for example, alcohol), intrauterine development is disrupted, and one of the consequences of the disturbance may be chest deformities . But these are just theories for now. And since the cause of the misfortune is unknown, then there are no methods of preventing it.

So different

There are two main types of deformation: funnel-shaped and keeled. Moreover, the first occurs ten times more often than the second. Dangerous consequences This disease has several. Firstly, the psychological discomfort experienced by children with a deformed chest. Secondly, improperly formed bones will subsequently compress the internal organs located nearby, which means problems with the cardiovascular and respiratory systems will begin. This is the insidiousness of the disease: on the one hand, it is not fatal, on the other hand, without treatment it entails many problems.

Surgery, which is best done after the end of the growth peak, will help to radically solve the problem with deformation.

What do doctors usually use to knock out the wedge?

Most often, operations are performed in June, so students and schoolchildren have time to recover before going to school. The operation takes place under general anesthesia and lasts about 1.5 hours. The essence of the operation to eliminate wedge-shaped deformity is to remove the overgrown cartilage. The operation takes place in one stage, after which the patient spends 4-5 days in the hospital, then another 3 weeks at home. After this you can return to to the usual way life with one condition - don’t get into a fight and heavy loads do not give the body another 3-5 months. After this, you can and should start playing sports. The type of it doesn't matter, anything is possible - from swimming to boxing.

The operation to eliminate funnel-shaped deformity takes place in two stages. During the first, the chest is aligned and fixed in the corrected position using a special clamp. After 3 years, during the second operation, the fixator is removed.

Before, during and after anesthesia

Nikolay Goncharenko, head of the anesthesiology department of the Kyiv City Heart Center:

The anesthesiologist's task is to administer anesthesia in such a way as to minimally affect the child's condition and at the same time eliminate any pain effect. This is achieved with special drugs that are administered based on body weight. They have been tested many times and are safe, so they do not affect mental and physical development in any way. It is also important to know that the effect of the drugs may be different, and as a result, one child will wake up earlier, another later, but in any case it will be in strict accordance with the time predetermined by the doctor. To eliminate any risks in the postoperative period, the patient is under medical supervision. There are many contraindications to general anesthesia, so during preparation for elective surgery the patient is carefully examined, and if it does not correspond to the norm, the operation is postponed. You will also have to do the same if your child has a cold. If the young patient is healthy and develops according to his age, he should not have any problems with general anesthesia.

PROFESSIONAL EXAMINATION

Yakov Fishchenko, Ph.D., senior researcher State Institution "Institute of Traumatology and Orthopedics of the National Academy of Medical Sciences of Ukraine":

There are many types of treatment that are prescribed for chest deformities. Over the years of practice I have encountered different options. So, recently a 9-year-old patient came to me, who, on the advice of doctors, has been blowing into a trumpet for 4 years. This may be beneficial for the development of musical abilities, but no trumpet will help eliminate the deformation. It happens that 30-year-old and 40-year-old patients also present with this problem, although the deformity never occurs in adults. It turns out that a person lives with this disease for about 30 years, and only when, in addition to cosmetic discomfort, health problems begin (pain in the heart and sternum, ischemic disease, breathing problems, when it becomes difficult to breathe due to a compressed chest) - a person decides that it’s time to finally take charge of himself.