CLINICAL AND FUNCTIONAL CHARACTERISTICS AND ORTHOPEDIC COMORBIDITY IN CHILDREN WITH PECTUS CARINATUM ASSOCIATED WITH CONNECTIVE TISSUE DYSPLASIA

Introduction. Pectus carinatum (PC) is one of the most common axial skeletal growth anomalies in children, representing a typical phenotype of connective tissue dysplasia syndrome. In routine clinical practice, the management of such patients is often limited to isolated thoracometry and surgical correction. Due to the underestimation of the systemic nature of the connective tissue defect, comorbid degenerative spinal lesions and complicated forms of flat feet are diagnosed late, dictating the need for a comprehensive approach.

Objective of the study. To investigate the clinical and functional status, as well as the structure of concomitant polyfocal orthopedic pathology in children with pectus carinatum.

Material and methods. The study involved 84 children aged 6 to 18 years. The main group consisted of 62 patients with PC, while the control group included 22 healthy children.

Results. Children with PC predominantly exhibited an asthenic somatotype (66.1%) and body weight deficit. Thoracoplasty resulted in a significant increase in chest excursion, particularly in pubertal patients (up to 5.85±0.20 cm; p<0.01). A high incidence of concomitant pathology was identified, including longitudinal flat feet (Grade II — 46.1%) and scoliosis (Grade I — 57.1%). A trend toward the early onset of degenerative processes was noted: early polysegmental osteochondrosis was diagnosed in 29.0% of the examined patients. Due to decreased bone strength characteristics, the history of fractures in the main group was 38.7%, compared to 4.5% in the control group.

Conclusions. Children with PC constitute a high-risk group for developing concomitant orthopedic pathology and injuries. Surgical correction of the deformity should be integrated into a multidisciplinary management system, requiring long-term orthopedic monitoring.