Muthialu N, et al. - Considering the observation that using a modified Ravitch procedure (STRATOS titanium bars) for patients who were unsuitable for the minimally invasive Nuss procedure produced excellent cosmetic results but showed several fractures and displacements of the STRATOS bars, researchers reviewed all their STRATOS patients since first use in 2009 until 2014 regarding diagnosis, severity of pectus deformity, comorbidity, previous operations for pectus, age at bar implantation, the number of bars implanted and duration of implantation. Outcomes revealed an unexpectedly high incidence of bar fracture. The high fracture rate is distressing as it is unpredictable and has no clear aetiological factors. As the operation is performed (largely) for psychosocial and cosmetic reasons, the quality of the bars used in teenage pectus patients should not be jeopardized.