Results were graded according to Humphreys and Jaretzki and were termed “excellent” if the chest appeared to be normal, the scar was inconspicuous, and the symptoms, if any, had gone. If there was any residual or recurrent sternal depression or if the scar was bothersome, but in general the patient and the family were satisfied, the result was called “good.” Excellent and good results were considered “satisfactory.” In patients with persistent pain, unsightly scars, or sufficient asymmetry to cause embarrassment, but whose sternum was in a better position than before the operation, the results were termed “fair.” Сanadian pharmacy levitra If a second operation had been performed or was considered to be indicated, the result was termed “poor.” Fair and poor results were considered “unsatisfactory.”
Categoric data were arranged in contingency tables and Fisher’s exact test or the x2 test was used to establish significance; p values of less than 0.05 were considered to be significant. The test of McNemar was used for paired dichotomous observations. Continuous data were analyzed with the Kruskal-Wallis test, the Mann-Whitney U test, the signed rank test, and the Spearman rank correlation coefficient.
Cardiorespiratory symptoms were observed in a considerable percentage of the patients preopera-tively, including decreased exercise tolerance (51.3 percent), easy fatiguability (43 percent), inability to take deep breaths (37.5 percent), and shortness of breath, mainly on exertion (31.6 percent). Surgery was indicated for psychologic/cosmetic reasons in 55.2 percent and for physical symptoms in 30.5 percent. In 5.3 percent of the patients, the prospect of physical symptoms in the future was the main reason for surgery. At long-term follow-up, most of the cardiorespiratory symptoms were less apparent (Table 1).
During physical examination, the severity of the deformity in our patients was estimated by the surgeon and considered to be severe in 68.9 percent, moderate in 16.9 percent, and mild in 14.2 percent. There were two patients with Marfan’s syndrome. The deformities were classified according to Chin. Type 1 symmetric and localized deformity was seen in 33.2 percent, type 2 symmetric but diffuse deformity was seen in 23.7 percent, and type 3 localized or diffuse asymmetric deformity was seen in 43.1 percent.
Table 1—Percentage of Patients With Physical Symptoms Before the Operation and at Follow-up
|Diminution of exercise tolerance||51.3||36.0||<0.02|
|Shortness of breath on exertion||31.6||20.0||<0.02|
|Frequent upper respiratory tract infection||26.3||13.0||<0.02|
|Frequent lower respiratory tract infection||17.2||6.0||<0.02|