Orthotic Bracing for Treatment of Pectus Carinatum Deformities

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Pectus Carinatum, also called pigeon chest, is a deformity of the chest with narrowing of the ribs and protrusion of the sternum bone. The deformity may be symmetrical or asymmetrical.  Pectus carinatum usually has an onset in early adolescence and occurs more in males than females.

When the body becomes skeletally mature, the deformity becomes rigid and potential for correction is minimal.  Many individuals with pectus carinatum suffer decreased confidence and poor body image.  While cosmesis is a primary concern for most individuals; shortness of breath, decreased endurance and pain may also be associated.

Pectus excavatum, or “hollowed chest” is another type of deformity of the chest in which the ribs and sternum indent into a concavity of the chest.  This is more common than pectus carinatum.  While this too may just have cosmetic implications, at times this can impinge on the internal structures of the heart, lungs and other organs.

Depending on the severity, surgery may be indicated.  There are several surgical techniques available to treat this deformity.  Orthotic bracing may be an option but is far less effective that treating the pectus carinatum.

Orthotic (bracing) intervention for the treatment of pectus carinatum is a viable, conservative and cost effective approach. The orthosis is worn 23 hours per day for at least four months, possibly up to one year depending on age.  Pectus carinatum orthoses are usually constructed of a front and back metal bar with adjustable attachments on the sides under the arms.  There is a front panel and a back panel, which provides compression of the protrusion.

The adjustable side attachments are gradually tightened until the chest has reached a flat position.  The orthosis is worn directly on the skin and is contoured closely to the individual shape of each patient.  The patient continues to wear the orthosis the full time until the deformity no longer rebounds when the orthosis is doffed. Through regular follow-ups with the orthotist, reductions in wear time are determined while ensuring the deformity does not recur.  The wear time is gradually decreased and eventually the orthosis is only worn at night time until skeletal maturity.  A team approach including the patient, caregivers, orthotist, physical therapist and doctor is necessary to ensure the best possible outcome.

For more information contact Laura at Union Orthotics & Prosthetics Co. at laura@unionoandp.com