Poland's Syndrome
The Procedure
Poland’s syndrome is thought to be due to a kinking of the subclavian artery (the main artery to the arm and chest) at the sixth week in gestation. This causes abnormalities to the upper limb and chest. The features can range from mild to severe deformities.
The chest wall problems include abnormalities to the muscles of the chest wall (pectoralis major and minor, serratus anterior, latissimus dorsi and rectus abdominis), underdevelopment of the breast and nipple areolar complex and lack of axillary hair.
The upper limb problems can include a shortened arm and fingers and fused central fingers (symbrachydactyly).
Techniques to reconstruct the chest wall include :
- Reconstruction of the underlying chest wall deformity
- Reconstruction of the breast mound with a tissue expander which can be inflated to keep up with the growth of the opposite breast, and then replaced with a definitive implant
- Flap reconstruction using a pedicled latissimus dorsi flap or a free flap reconstruction (e.g. a TRAM flap).
