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Pectus Carinatum

What is pectus carinatum?
Pectus carinatum, sometimes called “pigeon breast,” is caused when the breastbone is pushed outward, and occurs only about a third as often as pectus excavatum.

Because it affects the appearance of children, pectus carinatum can cause psychological and social problems. Moreover, it can hamper the ability of the heart and lungs to function normally, and can cause pain in the chest, back and elsewhere. In addition, pectus carinatum is associated with scoliosis.

Mild cases of pectus carinatum can be treated with advanced chest-wall braces. Severe cases of pectus carinatum can be very successfully treated with surgery.

Chest-wall braces
A custom-fitted chest-wall brace pushing directly on the sternum has proved to be an effective treatment for mild pectus carinatum in children and teenagers. The brace works in much the same way as orthodontic braces work to correct the alignment of teeth, applying steady pressure over time to change the alignment of the sternum. As in orthodontics, children must be willing to wear the chest-wall brace for 14 - 23 hours a day.

Children with more severe pectus carinatum may require surgery to remove some rib cartilages and reposition the breastbone. The most commonly used operation is the Ravitch technique. Children’s National’s team of experts in the Chest Wall Deformity Program can help families determine the best treatment option for their child.

Ravitch technique
Using the Ravitch technique, surgeons create an incision along the chest, through which they remove cartilage and detach the sternum. They then implant a small bar above the sternum to hold it in the desired position. The bar is left in position until the cartilage grows back, and can support the chest in a normal position. That usually takes about 1 to 2 years. The bar is then removed during a same-day operation.

Pectus Carinatum - Departments & Programs - Children's National Medical Center