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This video demonstrates the use of chrondotomies in the Nuss procedure to allow the sternum to lift more safely in the most severe pectus excavatum cases. The authors found that in very severe cases, and in older patients with asymmetry, simply lifting the sternum with bars is not sufficient. The cartilages can fracture in undesirable places, and asymmetry is usually not addressed.
Therefore, the technique involved performing a 4 cm midline incision and conducting chrondrotomies in the locations where the costal cartilages needed to be leveraged. This approach provided a controlled way to lift the chest. In this case, a horizontal osteotomy was performed to reduce the asymmetry of the sternum, executed as a partial osteotomy.
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