Pectus Carinatum

Although the exact cause of pectus carinatum is unknown, genetics are thought to play a role. Children with pectus carinatum are at an increased risk of connective tissue disorders such as Marfan syndrome. Some children may also have other associated conditions affecting bones and cartilage such as scoliosis or kyphosis. Pectus carinatum is more common in boys than girls.

Symptoms and Diagnosis

Other than the physical appearance of the chest pushing outward, most children with pectus carinatum don’t experience any symptoms. Though younger children can be diagnosed with pectus carinatum, it generally becomes more apparent as children grow during early adolescence.

To diagnose pectus carinatum, your child’s physician will perform a physical exam. They will likely take an X-ray to get a closer look at the deformity as well as check for any other skeletal anomalies. Other tests such as echocardiogram (echo), electrocardiogram (EKG) and pulmonary function tests may also be performed. These tests will help determine if the chest wall deformity is affecting heart and lung function.

Treatment for Pectus Carinatum

Surgery is rarely needed to treat pectus carinatum. Because children have chest walls that are still flexible, the vast majority of cases can be treated using bracing techniques. Children with mild to moderate pectus carinatum can wear a customized brace that will apply pressure to the protruding breast bone and cartilage, helping to gradually reshape the chest wall. The brace, worn for several hours during the day as well as overnight, may need periodic adjustments as the child grows. The process can take up to two years to fully correct the deformity.

In children with severe pectus carinatum, a surgery known as the modified Ravitch procedure may be performed. With this repair, the surgeon will make a horizontal incision across the mid chest and remove the abnormal rib cartilage. This allows the sternum to be reshaped and pushed downward.

The average hospital stay after the Ravitch procedure is about four to seven days. Your child will be on restricted activity for about six weeks post-surgery. After six weeks, they can return to more strenuous activities. Your child will have periodic follow-up appointments with their surgeon to check on their progress.