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Chest Wall Deformity Correction Center and Bracing Clinic

Chest deformity is a common problem many kids and parents don’t talk about. Until now, an invasive, often painful surgery was the only option for children and teenagers facing this problem.

Rocky Mountain Hospital for Children is now the exclusive medical center in the western U.S. to offer the Dynamic Compression Device, an external, temporary bracing system as a method of correction for Pectus Carinatum, a common chest deformity which causes the sternum to stick out, sometimes called Pigeon Chest.

The Dynamic Compression Device is custom-made for each child and works very much like braces on teeth. The brace is adjusted to apply enough pressure to correct the chest deformity, but not so much that it’s too uncomfortable for the child to wear.

Exclusive Protocol and Expertise

Not only is the Rocky Mountain Hospital for Children the only facility in the western U.S. to offer this treatment, it is one of only three in the country. Additionally, Dr. Marcelo Martinez-Ferro, a world-renowned physician and the developer of the Dynamic Compression Brace, has personally worked in Colorado with RMHC pediatric surgeon Dr. Steven Rothenberg and his patients.

About the Chest Wall Center

The Chest Wall Deformity Correction Center at RMHC is located just minutes from Denver International Airport, one of the largest airports in the United States with nonstop flights to over 150 domestic destinations and nearly 1,800 daily flights, making it the most accessible chest wall repair clinic offering the Dynamic Compression Device in the country.

Schedule an appointment

To schedule appointment call 303-839-6001

The Chest Wall Deformity Correction and Bracing Clinic sees patients two Fridays each month between 8 a.m. and noon.

Located at:
Rocky Mountain Pediatric Surgery
2055 High St.
Suite 370
Denver, CO 80205

About Chest Wall Deformities

Chest wall defects are common congenital abnormalities occurring in up to one in 300 live births. The condition is about four times more likely to occur in boys than in girls.

What is Pigeon Chest?

Pectus Carinatum (PC) (also called Pigeon Chest) is a common pediatric condition identified by an overgrowth of rib cartilages that cause the chest to protrude forward.

There are three ways in which pectus carinatum occurs. The most common occurrence is in pre-adolescent males between the ages 11 and 14 during a growth spurt. The second most common is from birth. A pigeon chested appearance is evident in newborns and around age 2 or 3, the chest continues to grow more outward. The least common occurrence is after open heart surgery. In these cases, the sternum fails to heal flat and results in PC.

What Are The Symptoms?

Most people with Pectus Carinatum will develop normal hearts and lungs, but the deformity of the chest wall could prevent them from functioning at their optimal capability. Many people with PC, and children especially, will experience shortness of breath during activity, decreased endurance and sometimes chest pain.

In addition to the physical symptoms, there can also be psychosocial implications as well. The shape of the chest can cause embarrassment, lack of self-confidence and possible disruption to social connection through adolescence and into adulthood.

How Are Chest Wall Deformities Treated?

There are two ways to treat Pectus Carinatum. The first choice is the external bracing technique and the second is surgical intervention.

Bracing

External sternum bracing is non-invasive and produces excellent results without a surgical procedure. The chest is still compliant during childhood and adolescence so the pectus carinatum brace is an obvious choice of treatment as it causes the least amount of discomfort as it corrects the chest wall abnormality. Bracing of the chest applies pressure and encourages gradual movement to the sternum in the same way that orthodontic braces move the teeth into position.

The brace we use is called the Dynamic Compression Device (DCD), developed by the world-renowned physician Dr. Marcelo Martinez-Ferro. Dr. Martinez-Ferro has personally worked with RMHC pediatric surgeon Dr. Steven Rothenberg and his patients at the Chest Wall Deformity Correction Center.

The DCD Brace is the newest brace available for the external treatment of Chest Wall deformities. The brace consists of a front-cushioned compression plate that is held in place by multiple light-weight aluminum curved segments fastened together by screws to form a rigid belt. This plate then applies pressure at the apex of the protrusion. The DCD is customized for each patient and designed to fit tight to the chest and middle of the back; it is fairly small and not too noticeable under clothing.

The key to successful treatment with the DCD is wearing the brace. Patients are encouraged to wear the brace as much as possible, up to 23 hours per day. The brace can be removed for showering, bathing and when participating in sports but otherwise should be worn all other times. Once the physician has determined the correction has been made, the patient will transition into a “retainer” phase. During this time frame, daily wear will be reduced but is still necessary. On average, the treatment and retainer phases can last anywhere from six to twenty-four months or more depending on severity of PC and individual responses to the brace correction.

Surgery

Surgical correction for pectus carinatum is a well-established and recognized option for treatment when the option for using the Dynamic Compression Device is not appropriate.

Surgery to correct PC involves reshaping and/or removing abnormal rib cartilage. The sternum (breast bone) could also need revision or reposition. An incision would be made in the center of the chest to repair the abnormality. Post operative drains would be in place for three to six days after surgery and would be removed when drainage decreases.

Hospitalization after PC correction surgery could be anywhere from three to five days depending on the patient’s body and healing. The patient would also be under strict activity restrictions for a minimum of two to three months after surgery.

About the Dynamic Compression Device

What Does The Dynamic Compression Device Look Like?

Chest Wall Brace

The brace we use at Rocky Mountain Hospital for Children is called the Dynamic Compression Device (DCD), developed by the world-renowned physician Dr. Marcelo Martinez-Ferro. Dr. Martinez-Ferro has personally worked with RMHC pediatric surgeon Dr. Steven Rothenberg and his patients at the Chest Wall Deformity Correction Center.

The DCD Brace is the newest brace available for the external treatment of Chest Wall deformities. The brace consists of a front-cushioned compression plate that is held in place by multiple light-weight aluminum curved segments fastened together by screws to form a rigid belt. This plate then applies pressure at the apex of the protrusion. The DCD is customized for each patient and designed to fit tight to the chest and middle of the back.

What Is The Wear Schedule For The Brace?

The key to successful treatment with the DCD is wearing the brace. Patients are encouraged to wear the brace as much as possible, up to 23 hours per day. The brace can be removed for showering, bathing and when participating in sports but otherwise should be worn all other times. Once the physician has determined the correction has been made, the patient will transition into a “retainer” phase. During this time frame, daily wear will be reduced but is still necessary. On average, the treatment and retainer phases can last anywhere from six to twenty-four months or more depending on severity of PC and individual responses to the brace correction.

Is The Brace Noticeable?

The brace itself is fairly small and not too noticeable under clothing.

Does The Brace Hurt? Will There Be Any Side Effects?

The brace should not be painful. There will be times, such as adjustments, where patients might experience some discomfort but it shouldn’t be outright painful. Most children will say their chest is slightly sore after the initial fitting and subsequent adjustments. This can simply be treated with over the counter medications such as ibuprofen (Motrin/Advil) or acetaminophen (Tylenol).

If the patient has trouble sleeping with the brace, a memory foam or similar type padding can be helpful when placed over the mattress.

Is There Any Chance of a Recurrence After Treatment?

There is a very small chance that PC could re-occur after treatment with the DCD. Recurrence has most commonly been noted during a rapid growth spurt and typically several months after the correction. In those instances, we would begin treatment with the brace again until the correction was made.

What If The Brace Doesn’t Work?

If the brace has been worn as directed by the physician and has been worn for at least two years, surgical intervention may be considered. At this time, patient, parents and surgeon would discuss options and together form a plan of care moving forward.