To Brace Or Not To Brace: What You Need To Know About Pectus Carinatum Bracing

Source: https://pediatricimaging.org/diseases/pectus-carinatum/

Pectus carinatum affects about one in every 1000 teens. This is according to the National Center for Biotechnology Information (NCBI). Still, milder forms of the condition may occur in up to five percent of the population, with male teens more affected than females.

If your child has the condition, one of the treatment options is wearing a chest brace. The brace helps correct the pigeon-chested appearance that the condition causes. It reshapes the chest and gives the child a more normal appearance.

This article will discuss pectus carinatum, bracing as a treatment option, how pectus carinatum bracing works, and its benefits and risks.

Let’s dive right in.

What Is Pectus Carinatum?

Also known as keel chest or pigeon chest, this chest wall deformity results in the breastbone and ribs getting pushed outward. The condition is often asymmetrical, affecting one side of the chest more than the other. 

It is caused by an abnormal cartilage growth between the ribs and the breastbone. Most children develop it during periods of rapid growth.

There are two types of pectus carinatum:

• Chondrogladiolar Prominence: This is the most common type. It’s commonly referred to as chicken breast or keel chest. Children with chondrogladiolar prominence have the middle, and lower portions of their breastbone protruding and arc forward. 
  
  It’s not uncommon for some children with this type to have pectus carinatum on one side of the chest and pectus excavatum on the other.
  
  
• Chondromanubrial Prominence: Commonly known as pouter pigeon breast, this type of pectus carinatum is rare and can be more complex to treat. It results in the upper portion of the breastbone protruding forward. 
  
  

The appearance of pectus carinatum symptoms can be late and only noticeable when the child reaches puberty. But rapid breathing, asthma, pain or tenderness in the cartilage, and irregular depression in the chest during infancy or early childhood can indicate pectus carinatum.

The deformity can also affect children with conditions that affect connective tissues such as Down syndrome, Marfan syndrome, and Ehlers-Danlos syndrome.

The deformity gets worse as the child grows older. If untreated, the child can also develop scoliosis- a spinal anomaly. 

How Is Pectus Carinatum Treated?

Visual inspection is often enough to diagnose pectus carinatum. But radiography or a computed tomography (CT) scan can help to determine the severity of the condition. Once diagnosed, there are three treatment options for children. 

They include:

• Non-surgical bracing
• Surgical correction
• Cosmetic concealment
  
  

Pectus carinatum treatment depends on both timing and severity. Braces are an option for moderate cases. But diagnosis will have to be done early, so treatment starts early before the chest wall becomes too stiff or hard to be reshaped. Bracing is less effective for people over 19 years old. 

Doctors usually recommend surgery to remove the excess cartilage and bone for more severe or complicated cases. 

Bodybuilding or breast enhancement (for females) are the most common methods of cosmetic concealment. They help to sculpt the muscles around the chest wall to minimize the appearance of pectus carinatum protrusion. It helps to improve self-esteem and confidence in the patients. 

In mild cases, the doctor may recommend not doing anything significantly if it doesn’t affect the heart or lungs.

How Does Bracing for Pectus Carinatum Work?

Bracing is the first treatment option for young children with moderate pectus carinatum. It’s similar to wearing dental braces to straighten crooked teeth. The purpose of the chest brace is to apply pressure to the protruding breastbone and cartilage, push them back, and gradually reshape the chest wall.

Chest braces have two padded aluminum plates and adjustable straps for wrapping around the child’s chest. One plate sits in the middle of their back while the other gets fitted against the protruding breastbone. The purpose of the front plate is to put pressure on the protrusion. The back plate keeps the brace secure and stable.

The braces are usually thin and unnoticeable when worn under the clothes.

If a child needs a chest brace, it will be custom-made to fit them. The doctor customizes the brace specific to the child’s measurements and the shape of the protrusion. Periodic adjustments are usually made as the child grows. 

The child will wear the brace at home and when sleeping, ideally for at least eight hours a day. It takes about a year for the protrusion to completely disappear. It’s important to remember that the treatment length will depend on how long and consistently the child wears the brace.

Benefits of Using a Brace for Pectus Carinatum

Compared to surgical treatment, using braces for pectus carinatum have many benefits. 

Some of the benefits are:

• Brace fitting and adjustments are easily accessible at outpatient healthcare facilities 
• Braces also don’t leave any permanent scars 
• There are no risks of infection from surgical operations or the side effects of general anesthesia
• Bracing for pectus carinatum is much more affordable
  
  

Potential Risks of Using Braces for Pectus Carinatum

Using braces here doesn’t have any significant health issues. But they may be uncomfortable at the beginning and it will take time to adjust to wearing one.

It’s common to experience redness, irritation, or soreness around the skin covered by the brace. These can go away within 30 minutes after taking the brace off. No special treatment is needed. If they don’t disappear, you should talk to a doctor as soon as possible. 

Consult a specialist too if the braces feel painful or the child is experiencing skin inflammation such as rashes and blisters.

If the child doesn’t want to follow through with the rigorous pectus carinatum bracing process, a surgical procedure might be recommended.

Pectus Carinatum Bracing FAQs

Here are some of the most frequently asked questions about pectus carinatum addressed:

1. What's the best age to start chest bracing treatment?
Bracing for pectus carinatum depends on several factors, such as the condition's severity and the protrusion's position. But the optimal age to start bracing treatment is between 12 to 16 years when the chest is still maturing and flexible. Permanent correction without surgery is achievable at this age.

2. How long does my child need to wear pectus carinatum braces?
For most kids, bracing treatment lasts between six months to one year. Some may need it longer. It’s advisable to wear the brace for at least eight hours, but they can be removed when engaging in sports, showering, or doing other activities.

It’s advisable to wear the brace exactly as prescribed by the doctor in order to get the best results.

3. Will pectus carinatum braces affect my child’s quality of life?
No. Apart from the mild side effects described above, using braces for pectus carinatum won’t affect your child’s quality of life. They will be able to engage in their hobbies and other activities. Treatment with a chest brace tends to have good results.

4. How often do I need to come in for check-ups and readjustment appointments? 
Regular reviews are part of the treatment program and the number of doctor appointments needed varies. But younger patients growing at a faster rate need more regular appointments and brace readjustments.

 Get Treatment for Pectus Carinatum

Align Clinic has been providing treatment for pectus carinatum treatment for over 10 years. We achieve positive results in our patients. If you think your child might have the condition or is displaying any of the pectus carinatum symptoms, visit any of our clinics for a free consultation. 
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Book an appointment online.