What is it?
Pectus carinatum (PC) is a common pediatric condition characterized
by an abnormal overgrowth of the rib cartilages, which results in
protrusion of the breastbone (sternum) and rib cartilages.
PC is observed more frequently in males than in females (4:1
The cause of PC is unknown; however, it may be genetically
linked considering its frequent occurrence in families.
Many people with pectus carinatum will have shortness of
breath with activity, decreased endurance or chest pain. Some
children and their parents report that the children feel
embarrassed about the appearance of their chest.
How is it
Bracing is the treatment of choice for pectus carinatum because
the chest is still compliant (flexible) during childhood and
The brace used at Children's Mercy Hospitals and Clinics, called
the dynamic compression device (DCD), is the newest brace available
and is on the cutting edge of treatment for pectus carinatum. It
corrects the abnormal chest shape and allows remodeling by applying
external compression (similar to the way braces correct crooked
The pectus brace uses the least amount of pressure needed to fix
the chest in order to maximize comfort. It will be adjusted
(tightened) every few months until the chest has a normal
the brace look like?
The brace has a number of screws that are needed to make bracing
adjustments. These screws may need to be tightened once a week.
Only the black screws should be tightened. You can
do this at home using a manual screwdriver. The silver screws that
hold the front compression plate in place should
not be manipulated.
How long does the
brace need to be worn?
We recommend that the brace be worn as much as possible
(23 out of 24 hours a day) every day for optimal correction. The
brace only works when it is worn as prescribed. Wearing the brace
as often as possible throughout the day and night (excluding
showers and sports) will allow the best correction outcome.
The typical length of time needed to wear the brace for full
correction will vary from person to person. On average, the brace
will need to be worn for six-to-20 months. After the chest becomes
a more normal shape, the brace will still need to be worn less
often in "retainer mode."
During brace therapy, your child will be taught exercises by our
physical therapist. Completing
these exercises daily will strengthen the chest and optimize
The brace can easily be worn under clothes. Some prefer to
wear a thin, tightly-fitting shirt under the brace for comfort.
the brace hurt? What are the side effects?
- Most children say their chest is slightly sore after the
initial brace fitting. This can be treated with ibuprofen (Motrin)
or acetaminophen (Tylenol).
- Your child may experience slight redness and pain on the front
of the chest from the brace. This is normal.
- If the brace causes a scratch or sore that is open, this is not
normal and the brace should be removed.
- If you remove the brace and the reddened area on the chest does
not "blanche," you need to remove the brace and call the office.
Blanching is when you press on the red area and it temporarily
turns white and then back to red. Do not put the brace back on
until the reddened area can blanche.
- If the problem continues, the child should not replace the
brace until he/she can be seen in the clinic for adjustments.
- If your child has trouble sleeping with the brace on, try using
memory foam or a similar-type padding over the mattress.
- Girls should not use the brace with an underwire bra as this
may cause pain and skin breakdown.
- If you have questions or concerns about the brace, please call
the Surgery Clinic: South (913) 696-8570 or Downtown (816)
What if the brace doesn't
If your child has been compliant wearing the brace
(wearing it as often as possible, as prescribed), and has been
trying it for about two years, we may consider surgery to correct
his/her pectus carinatum.
Surgery involves reshaping/removing the abnormal rib cartilages
while preserving their outer layer, allowing new cartilage to grow.
The breastbone may also need to be revised and/or repositioned. An
incision is made in the center of the chest to repair this
abnormality. Post-operative drains (soft, flexible tubes) will be
in place for three-to-six days and will be removed when the
Children are usually hospitalized for three-to-five days and
would have strict activity restrictions for two-to-three months
Physician News: Children's Mercy Pioneers
Treatment of Chest Deformity
Read an article written by the developers of
Children's Mercy Center for Pectus Excavatum and
Children's Hospital of the King's Daughters
These websites are for informational purposes only. Surgical
technique and care will be dictated by your surgeon. Please use
these to find out more information about Pectus Carinatum, but
remember that these sites are provided for educational purposes and
may not be affiliated with Children's Mercy Hospitals and Clinics.
Information should not be viewed as a substitute for medical advice
provided by your family doctor, pediatrician or