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Analysis of 40-year experience with operations for pectus excavatum over the period from 1950-1988 is presented. In a series of 177 children ten different surgical approaches were used in succession. Since 1975 operations were performed exclusively by the method according to Ravitch and Welch which does not apply any fixation splints. The procedure is substantiated by the pathologico-anatomical and metabolic causes of the origin and development of inborn deformities of the chest. The operation consists of several exact procedures on the muscles, cartilages, and sternum, which have to be carried out consistently. The important parts of the surgical procedure are described. Since 1975 the method was used in 28 children, with very good and good results in 92.8%.
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