As part of the spectrum of chest wall anomalies, some patients present with abnormalities of growth of the ends of the rib cartilages. These may be part of a more global pattern of deformities as are seen in patients with diagnoses such as Poland’s anomaly, in which bone, cartilage, skin, muscle and breast tissue, as well as the hand, may be involved. In these cases, a more extensive approach may be required and, depending on the details of what tissue is involved, a tailored reconstructive plan will be generated.
Alternatively, the rib anomaly may be an isolated finding: For example, in normal anatomy, the rib cartilages of ribs7-10 are usually united in a synchondrosis, while the ends of ribs 11 and 12 are free, the so-called ‘floating ribs”. If the terminal rib cartilage is deformed, it may grow inward, in some cases, causing chronic pain by pressure on the liver capsule and creating a hollow in the lower edge of the thoracic wall, which is easily seen in the thin person. These sorts of rib deformities are readily treated by local surgical procedures with resection and reshaping of the offending rib cartilage(s).