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September 1979

'Railroad Track' Operation

Arch Surg. 1979;114(9):1091-1092. doi:10.1001/archsurg.1979.01370330113025

To the Editor.—My father, who has retired from the private practice of thoracic surgery, has asked me to respond to the article by Fonkalsrud et al (Archives 113:1433-1437, 1978) entitled "Pectus excavatum repair using autologous perichondrium for sternal support." The operation that he described is quite different than the description of it by Fonkalsrud et al.

I remember hearing of the "railroad track" operation when I was a child. Although I did not understand it at the time, my father was using a sterilized piece of model railroad track as an external support to repair the pectus excavatum. While doing one of these operations, for reasons he is unable to characterize, he left the lower two costal cartilages attached to the body of the sternum while he carried out the dissection. After performing an osteotomy on the sternum and elevating the body of the sternum, he found that a

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