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Musculoskeletal abnormalities

OA/TOF patients have musculoskeletal abnormalities as a result of thoracotomy as well as those discussed due to the VACTERL association. Of those who had open thoracotomy, 33% had sequaelae.(8) These include:

  • Scapula winging
  • Thoracic wall asymmetry
  • Scoliosis – in keeping with other causes of scoliosis, these usually present in adolescence with the growth spurt (136)

This can be symptomatic, with more than 75% reporting shoulder height differences, 20% limited movement of the right arm and 14% asymmetry of the chest wall and breast asymmetry. These anomalies are often mild, but a proportion will need surgical treatment and referral to orthopaedics or breast surgeons.