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August 1958

Pigeon Breast—Congenital Chondrosternal Prominence: Etiology and Surgical Treatment by Xiphosternopexy

Author Affiliations

Newark, N. J.
Thoracic Surgeon, Newark Beth Israel Hospital.

AMA Arch Surg. 1958;77(2):261-270. doi:10.1001/archsurg.1958.01290020111022

The three deformities of the anterior chest wall commonly referred to as funnel chest, pigeon breast, and Harrison's groove I believe1,6-8 to be congenital and produced during infancy by abnormal, unbalanced contractions of an abnormally developed diaphragm. This etiology of pigeon breast, when first proposed in 1949,1 was justifiably questioned because of the paucity of the evidence then submitted. I shall present further evidence to support this theory. Until recently rickets was generally accepted as the etiologic factor in this deformity, and little has been written concerning it beyond Lester's2 proposal that it is primarily due to the abnormal overgrowth of the involved ribs. Recently, Chin,3 in the 1956 Hunterian Lecture delivered before the Royal College of Surgeons, came to the support of my diaphragmatic theory with biopsy and autopsy studies of diaphragms, as well as the description of a very effective operative procedure based on

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