Pediatric Pectus Carinatum

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.

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 Hospital's team of experts in the Chest Wall Defects Program can help families determine the best treatment option for their child.

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 one to two years. The bar is then removed during a same-day operation.