Surgical Repair of Chest Wall and Pectoral Deformities in Poland Syndrome in Children

Poland syndrome is a rare congenital condition characterized by absence or underdevelopment of the sternal head of the pectoralis major muscle on one side, often with ipsilateral breast and chest wall hypoplasia (though concomitant hand anomalies are beyond our scope). Severe deformities may also include absent ribs or asymmetric chest. 3D imaging (such as MRI) vividly demonstrates the unilateral chest depression and muscle absence. For example, the MRI above (right side views) shows a profound right anterior chest wall depression with no right pectoralis muscle visible; the left side (normal) is indicated by the dashed line. Such imaging is valuable in preoperative planning. Surgical correction is generally reserved for the more severe thoracic defects. In Romanini’s classification, only grades T2–T4 (the moderate-to-severe forms) typically warrant operative repair [1,2]. In practice, pediatric patients with significant chest asymmetry are referred for reconstructive surgery to restore chest contour and stability.