What to know about bracing for Pectus carinatum

If your child has pectus carinatum, your doctor might recommend a chest brace to correct the pigeon-chested appearance that the condition causes. Chest braces can help to reshape your child’s chest, relieve any symptoms, and give them a more normal appearance.

By Nicole Wu  WebMD May 04, 2022. Medically Reviewed by Dany P. Baby, MD

Keep reading to learn about using a brace for pectus carinatum, how it works, the risks, benefits, and some of the possible outcomes you can expect.

What is Pectus carinatum?

Pectus carinatum is a condition that makes your chest look like it’s bowed or jutted outward. It happens when the cartilage that connects your ribs and sternum (breastbone) grows abnormally or more than it should.

Pectus carinatum is a rare condition that affects about one out of every 500 children and is more common in boys than girls. It can affect one or both sides of the chest, and even though it is present at birth, symptoms don’t usually begin until your child is around 10 to 13 years old or beginning puberty. While the exact cause is unknown, pectus carinatum may be linked to genetic or inherited traits because it sometimes runs in families.

Pectus carinatum also affects some children with Down syndrome, Marfan syndrome, Ehlers-Danlos syndrome, or other conditions that affect their connective tissues.

How Is Pectus carinatum treated?

Pectus carinatum treatment depends on both timing and severity. In rare instances, people with very severe or complicated cases might need surgery to remove excess bone and cartilage and correct the issues it causes.

Mild or moderate cases can usually be treated with external brace therapy if caught early enough before the chest wall gets too hard or stiff to be reshaped. Bracing is most effective during a growth spurt or while your child is in early puberty and is less effective for young adults or people over 19 years old.

If pectus carinatum symptoms don’t affect your child’s lungs or heart, they might not need any treatment unless for cosmetic reasons.

How does bracing for Pectus carinatum work?

Bracing for pectus carinatum is often compared to dental braces that straighten crooked teeth.

If your child needs a chest brace, it will be custom-made to fit them. The brace will have adjustable straps to wrap around your child’s chest and two padded aluminum plates. One plate will sit in the middle of their back, and one plate will fit against their breastbone or the part of their chest that juts out. The front plate works by putting pressure on the parts of their chest or ribs that jut out incorrectly, and the backplate keeps the brace secure and stable.

Consistently wearing their brace will help push your child’s breastbone back in, relieving any symptoms, and giving them a more normal appearance. While using a chest brace, your child will have regular visits with their doctor to check their progress and make adjustments as necessary.

If your child is worried or embarrassed about wearing their brace in public, they can rest easy. Chest braces are designed to be thin and usually won’t be noticeable when worn under a t-shirt. Your child can wear their brace either under or over their clothes, whichever way they feel the most comfortable.

How long will my child have to wear a chest brace?

Your child’s doctor will make a plan for how long your child needs to wear their pectus carinatum brace based on their needs and goals.

At first, your child will wear their brace for a little while each day and eventually build up to wearing it for longer times. A minimum of 8 to 12 hours a day is usually recommended.

On average, most children will have to wear their braces regularly for around 6 to 12 months. Braces can be taken off when necessary, but the longer and more frequently they are worn the better their results will be.

After the initial treatment period, pectus carinatum braces can be used similarly to dental retainers. Your child’s brace can be worn for less time to help keep their bones in place until they mature and harden.

What are the risks of using a brace for Pectus carinatum?

Wearing a pectus carinatum brace usually does not cause any significant health problems.

Chest braces can be uncomfortable for some children, and it might take some time for them to adjust to wearing one every day.

Some children might have skin that becomes red or irritated by the brace, but this should go away without any special treatment within about 30 minutes of taking the brace off.

Make sure to talk to your child’s doctor if their brace feels painful, their redness isn’t going away, or they have other skin inflammation like rashes, sores, or blisters.

What are the benefits of using a brace for Pectus carinatum?

Bracing for pectus carinatum has many potential benefits compared to surgical treatment.

Fitting and adjustments for chest braces can be done easily as outpatient procedures at clinics rather than in a full hospital setting.

Unlike surgical treatment, there isn’t any risk of infection or side effects from the operation or from using general anesthesia.

Pectus carinatum braces don’t leave any permanent scars or cause other cosmetic issues.

Braces are generally much more affordable than surgery and can achieve similar results.

What are possible outcomes of bracing for Pectus carinatum?

Pectus carinatum bracing outcomes will be different for each person depending on their needs and how consistently they wear their brace.

For the best possible results, make sure to have your child regularly wear their chest brace and follow your doctor’s orders closely. Results are often seen quickly after beginning chest brace therapy, but it’s important to keep wearing the brace as instructed.

If your child regularly and correctly wears their chest brace for more than 6 months, they are unlikely to have any reoccurrence or need further treatment.

If your child doesn’t wear their brace according to their doctor’s orders, they might need surgery later to correct any problems after their bones and cartilage harden.

Source WebMD

  Further reading

External Compressive Bracing With Initial Reduction of Pectus Carinatum: Compliance Is the Key, Fraser S, Harling L, Patel A, Richards T, Hunt I. Ann Thorac Surg. 2020 Feb;109(2):413-419. doi: 10.1016/j.athoracsur.2019.08.026. Epub 2019 Sep 23. Full text

Effectiveness of Compressive External Bracing in Patients with Flexible Pectus Carinatum Deformity: A Review, Hunt I, Patel AJ. Thorac Cardiovasc Surg. 2020 Jan;68(1):72-79. doi: 10.1055/s-0039-1687824. Epub 2019 Apr 25.

Long-Term Results of Compressive Brace Therapy for Pectus Carinatum, Moon DH, Kang MK, Lee HS, Lee S. Thorac Cardiovasc Surg. 2019 Jan;67(1):67-72. doi: 10.1055/s-0038-1669927. Epub 2018 Sep 14.

Bracing of pectus carinatum: A quantitative analysis, Bugajski T, Murari K, Lopushinsky S, Schneider M, Ronsky J. J Pediatr Surg,. 2018 May;53(5):1014-1019. doi: 10.1016/j.jpedsurg.2018.02.034. Epub 2018 Feb 13.

Clinical experience with orthotic repair of pectus carinatum, Al-Githmi IS. Ann Saudi Med. 2016 Jan-Feb;36(1):70-2. doi: 10.5144/0256-4947.2016.70. Full text, PDF

Factors affecting patient compliance with compressive brace therapy for pectus carinatum, Kang DY, Jung J, Chung S, Cho J, Lee S. Interact Cardiovasc Thorac Surg. 2014 Dec;19(6):900-3. doi: 10.1093/icvts/ivu280. Epub 2014 Aug 27.

Also see
☞ Pectus carinatum – FAQs
☞ Braceworks Pectus Brace wear and care
☞ Pectus carinatum bracing – FAQs for parents
☞ Pectus carinatum: surgery or bracing
☞ Dynamic bracing of pectus carinatum: a quantitative analysis
☞ Bracing in pediatric patients with pectus carinatum is effective and improves quality of life

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