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Poland's syndrome in women: 24 cases study and literature review.

BACKGROUND
Since its first description in 1841, numerous variations and treatments of Poland's syndrome (congenital deficiency of the pectoralis major muscle associated with brachysyndactyly) have been reported. None of the reports, however, involved female Chinese patients.


METHODS
A retrospective study of 24 female patients was conducted to guide the selection of methods of surgical reconstruction. The patients were divided into three groups according to the degree of thoracic tissue development. Type I (mild): Limited tissue loss which can be treated with simple filling with autologous fat and/or an artificial breast implant. Type II (moderate): Moderate thoracic tissue hypoplasia where the breast parenchyma can still offer adequate implant coverage. Mammoplasty using a latissimus dorsi muscular flap with an implant was performed in this group. The flap was used to fill the infraclavicular hollow, and the implant was placed in the dual-plane pocket. Type III (severe): Severe thoracic tissue hypoplasia, without sufficient parenchyma to offer implant coverage. A latissimus dorsi muscular flap was used to form a total submuscular pocket in which an implant was placed.


RESULTS
The numbers of Type I, II, and III patients were 15, 3, and 6, respectively. All of the flaps and injected fat demonstrated good survival. Satisfactory cosmetic results were exhibited during the follow-up period of 1 to 9 years.


CONCLUSIONS
Although this group of patients showed varied conditions, they can be roughly divided into three types according to the degree of thoracic tissue development. In our experience, this classification is simple and useful in choosing the breast reconstruction options.