Four cases requiring exchange or adjustment of the pectus bar because of thoracic growth following the nuss procedure

In order to prevent a recurrence after bar removal, we leave the pectus bar in place for about 3 years. We experienced several cases where we were required to exchange or adjust the bar because of stabilizer dislocation and transformation of the ribs resulting from thoracic growth. The patients were 4 male patients between 7 and 12 years of age. Between two years 4 months and one year 6 months after the operation, the patients experienced chest pain, an indentation to the rib of the bar, and transformation of the ribs. We adjusted the curve of the detention bar for two patients and exchanged the bar for the other two patients.