Charles W. Lester, M.D.
JAMA. 1954;156(11):1063-1067. doi:10.1001/jama.1954.02950110025009.
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Congenital deformities of the anterior chest wall are among those conditions that, by definition, comprise the specialty of orthopedics. For many years they were neglected, but now physicians, particularly pediatricians, are becoming increasingly aware of the handicaps that they produce and are referring patients with these deformities for corrective surgery. In general, the deformities may be classified in two categories, the protrusion deformities and the depression deformities. These are the results of congenital or developmental abnormalities and are not related to acquired defects due to rickets or other diseases. They have a strong hereditary tendency, and both types of deformity may appear in the same family.

PROTRUSION DEFORMITIES  The protrusion deformities may be in the midline and involve the sternum (pectus carinatum); they may be lateral to the sternum and involve the costochondral junctions; or they may be in the costal arch. When the protrusion is in the midline the


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