eComment. Dilemma of the costal cartilage overgrowth in chest wall deformities

We have read with interest the article by Chul Hwan Park et al. [1]. The authors suggest a hypothesis for the cause of pectus carinatum deformity. We wish to add our comment on this topic. In the Results part of the article, only the mean values of the fourth, fifth, and 6th ribs are given. We think that the values of each rib compared with the rib on the aopposite side would be more illustrative than the mean values. The mean values of the ribs may not be statistically important, but if the length of a rib is different from its aopposite matching rib, this is important and should be mentioned. Also, the patients should be classified as having sternal rotation, scoliosis, or neither of these, and each of these groups should be evaluated separately. The ribs start from the vertebral body and slope down to the sternum with a unique angle in each individual. If a deformity in a vertebral body is present, a deformity of the thoracic cage is likely in that individual. Also, if sternal rotation is present, the costal cartilages will be depressed or will protrude to reach the sternum. We think that the length of the ribs is the same on the depressed and the protruded side in patients who have scoliosis or sternal rotation and that the primary deformity is the vertebral or sternal deformity. Conflict of interest: none declared