Chest wall deformities are uncommon conditions that affect the shape of your child’s ribs. While no one knows why these conditions occur, it may be related to genetics.
The two most common types of chest wall deformities include:
Pectus Excavatum: Also called a "funnel chest," kids with this condition have an indented or sunken sternum (center of the rib cage). It affects 1 out of every 500 children.
Pectus Carinatum: Also called a "pigeon chest," the sternum bulges out of the chest in children with this condition. It affects 1 out of every 1,500 children.
Caucasian children and boys are more likely to develop chest wall deformities.
Your child may feel embarrassed by their chest wall deformity, especially as they become teenagers. Chest wall deformities can also affect your child’s ability to participate in sports or other physical activities. You can help your child boost their self-esteem and be more active by seeking treatment for their chest deformity.
How are chest wall deformities treated?
Adam Alder, M.D., Director of the Center for Pectus and Chest Wall Abnormalities at Children’s Health℠, and his team provide comprehensive care for chest wall anomalies. You and your child will work with the doctor to determine the right treatment for your child.
Your child’s treatment options may include:
Customized bracing to remold the chest with gentle pressure
Physical therapy to improve posture and upper body strength
Nuss or Ravitch Procedure for pectus excavatum
Ravitch Procedure for pectus carinatum
How does chest wall bracing work?
Our Center is one of the few in the United States with a dedicated team trained to complete customized measurements of the chest, supply the brace and provide follow up.
Your child may use two different types of braces for pectus carinatum:
- A circular brace that is not customized
- A dynamic compression brace that is made according to your child’s measurements
When your child first receives the brace, they will wear it for just a few hours, slowly building up to wearing it all day. Once your child’s chest begins to reach the desired shape, they will wear the brace less and less, to retain the shape. Your child may wear the brace for as little as six months or as many as 20 months.
What is surgery like?
Your child’s surgery experience depends on the procedure. Most often, surgery is recommended around age 13, but may be performed sooner or later depending on your child’s needs.
Nuss Procedure: This minimally invasive procedure uses just two incisions on the sides of the chest. The physician uses these incisions to place a metal bar behind the sternum, lifting it up into place.
Ravitch Procedure: During this procedure, the physician makes an incision in your child’s chest so they can remove the abnormal rib cartilage that is causing the "pigeon chest." The surgeon then pushes the sternum into the correct shape and places a metal bar to hold it in place.
For both procedures, the metal bar will remain in your child’s chest until the ribs and sternum are remolded into the correct shape. Your child will then have another procedure to remove the bar. Your child’s care team will discuss a recovery plan with you and your child, which may include pain management and physical therapy.
For more information on chest wall abnormalities or to have your child evaluated for treatment, contact The Center for Pectus and Chest Wall Anomalies at Children’s Health.
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