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Chest wall

Chest wall

Chest wall deformity

The surgical team at Shriners Hospitals for Children — Portland treats chest wall abnormalities of all degrees. Two of the most common forms of chest wall irregularities are pectus excavatum and pectus carinatum.

Pectus excavatum (sunken chest)

Pectus excavatum is an indented or depressed breastbone (sternum). Often present at birth, the condition becomes more pronounced in early adolescence during growth spurts. Though mostly a cosmetic deformity, pectus excavatum rarely can lead to compression and displacement of the heart and lungs. 

In the past, a lengthy invasive operation was required to correct the indentation in the sternum. The Portland Shriners Hospital has helped hundreds of patients by using a minimally invasive technique called the NUSS procedure. Instead of removing rib cartilage and cutting the sternum, a metal bar is implanted to push the sternum up, correcting the indentation with minimal scarring. This is a highly specialized procedure, which is performed by our experienced physicians.

Pectus carinatum (raised chest or pigeon chest)

In pectus carinatum, the breastbone (sternum) protrudes out. More common in boys than girls, it often becomes present around age 11 and progresses as children grow.

In pectus carinatum, bracing is the first option to correct the deformity. Working with the Pediatric Prosthetic and Orthotic Services – Northwest, LLC, department at the Portland Shriners Hospital, we have provided patients with custom-fitted braces that apply direct pressure to the protruding sternum, shifting the chest wall back to a normal shape, and have found this kind of bracing to be a safe and effective solution. The more a patient uses the brace in a given day, the faster his or her chest will be corrected. Some patients have a correction in as few as six months when the brace is worn 20 hours a day. We have treated hundreds of patients successfully, thus avoiding surgery.

Patient evaluation

All care delivered at Shriners Hospitals for Children — Portland is focused on the needs of children. The physician will evaluate your child and may order tests as needed (e.g. X-rays), and create a treatment plan, which may include bracing and/or surgery. The specialized medical team works collaboratively to ensure that children benefit from the finest, most advanced specialty care.