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With an elevated sternum there is no risk of heart displacement or its compression. However, around the age of 19 years the increasing rigidity of the chest may reduce patient's fitness level, and enhance an existing scoliosis.

The incidence of pectus carinatum is much lower than the incidence of pectus excavatum, but actual statistics is not known. Recent studies from Canada (2019), and much earlier from Argentina  clearly demonstrate much higher numbers for pectus carinatum than excavatum. The explanation is easy and shows poor detection of PC cases which were not registered and referred for treatment, which was of dubious value at the time. 

Pectus carinatum comes in symmetric or asymmetric forms. All are repairable through non-operative treatment with bracing, which is a first choice approach. Only a horseshoe deformity needs surgery around the age of 19 years.

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Right and left-sided elevation of the sternum and cartilages

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Localised elevation of the sternum

Horseshoe deformity cannot be treated with a brace, because of its rigidity. We have a limited experience in very young children with possible hope for improvement because of poor compliance to treatment in this age group. Any surgery before attaining full rigidity of the chest may end up in rather poor results.