Non-operative treatment in pectus carinatum
Compressive external bracing appears a first choice treatment for pectus carinatum in young children with a pliable chest. There is an age limit of 19 years beyond which a nonsurgical treatment seems impossible. Our own experience in much older patients contradicts this observations.
The nonsurgical treatment consists in gradual compression on the chest with a brace applied directly on to the elevated part. The bracing follows a course of physiotherapy focused on increased mobility of the whole body, particularly its upper part. Each orthosis is custom-made and gradually tightened in time while the chest itself undergoes the process of reshaping with increasing its width vs. height at the point of the highest elevation. The duration of the treatment is usually 1 year or less with mostly excellent results in properly selected patients.
Complete correction of pectus carinatum
Surgical treatment of pectus carinatum
Surgical treatment is limited to horseshoe deformities because of their rigidity and thus unresponsiveness to any kind of external bracing. There is a limited experience in very young children but their poor compliance often results in an early dropout.