Chest wall deformities in children generally fall into two main categories : Pectus excavatum , where the front of the chest dips inwards forming a "crater and Pectus carinatum where the chest wall pushes outwards.
Both conditions are due to abnormal growth of the cartilagenous part of the ribs which attache to the sternum. These abnormalities can become apparent from birth and from any point after birth. They usually become significantly more obvious during the pubertal growth spurt. They tend not to be associated with other significant abnormalities although there is often some curvature of the spine ( scoliosis).
There is little evidence that the condition affects cardiac or respiratory function significantly. They can however cause considerable anxiety, embarrasment and poor self esteem in children and adolescents. Where this is the case, there are procedures that we can do to correct these deformities. Most pectus carinatum can now be corrected with the use of external bracing. Pectus excavatum is succesfully treated by the insertion of a metal bar behind the sternum called a ""Nuss"" bar. This procedure grants immediate correction, but the bar does have to be in place for 2 to 3 years. We do not consider performing this procedure until the child has significantly gone through the pubertal growth spurt in order to achieve optimal and sustained results.