Exclusive chest wall deformity treatment in Denver
Until recently, an invasive, often painful surgery was the only option for children and teenagers facing a chest wall deformity. Rocky Mountain Hospital for Children (RMHC) in Denver, Colorado is the only medical center in the western U.S. to offer the non-invasive dynamic compression device—an external, temporary bracing system for chest deformity correction.
For more information about our clinic, please call (303) 860-9933.
The dynamic compression device is used as a method of correction for pectus carinatum (PC), 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.
Not only is the RMHC the only facility in the western U.S. to offer this treatment, we are 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 Denver with RMHC’s pediatric surgeons and their patients.
About pectus carinatum
Pectus carinatum is a common pediatric condition identified by an overgrowth of rib cartilages that cause the chest to protrude forward. The condition is about four times more likely to occur in boys than in girls.
There are three ways in which PC occurs. The most common occurrence is during a growth spurt in pre-adolescent males between 11 and 14 years old. The second most common is from birth—a pigeon-chested appearance is evident in newborns, and between two and three years old, the chest continues to grow further outward. The least common occurrence is after open heart surgery. In these cases, the sternum fails to heal flat and results in PC.
Pectus carinatum symptoms
Most children with PC develop normal hearts and lungs, but the deformity of the chest wall could prevent them from functioning at their optimal capability. Many children with PC will experience shortness of breath during activity, decreased endurance and some chest pain.
In addition to the physical symptoms, there can also be psychosocial implications. The shape of the chest can cause embarrassment, lack of self-confidence and possible disruption to social connection through adolescence and into adulthood.
Pigeon chest treatments
There are two ways our Denver pediatric specialists treat PC at RMHC. The first option is the non-invasive, external bracing technique, and the second option is with pediatric surgery.
External sternum bracing with the dynamic compression device (DCD) produces excellent results without a surgical procedure. The chest is still compliant during childhood and adolescence, so the DCD is an obvious choice of treatment because it causes the least amount of discomfort as it corrects the chest wall abnormality.
Bracing of the chest applies pressure and encourages gradual movement of the sternum in the same way that orthodontic braces move the teeth into position. The DCD is the newest brace available for the external treatment of chest wall deformities.
It consists of a front-cushioned compression plate that is held in place by multiple light-weight, curved aluminum segments fastened together by screws to form a rigid belt. The plate then applies pressure at the highest part of the protrusion. The DCD is customized for each child 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 consistently. 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 it should be worn at all other times.
Once the physician has determined the correction has been made, the patient will transition into a “retainer” phase. During this phase of treatment, daily wear of the brace will be reduced. On average, the treatment and retainer phases can last anywhere from six to 24 months or more, depending on severity of PC and the child’s responses to the brace correction.
FAQs about the bracing technique
There will be times, such as after adjustments, where children may experience some discomfort, but it should not be painful. Most children will say their chest is sore after the initial fitting and subsequent adjustments. This can be treated with over-the-counter medications, such as ibuprofen (Motrin/Advil) or acetaminophen (Tylenol).
If your child has trouble sleeping with the brace, apply a memory foam or similar type of padding over the mattress for increased comfort.
There is a very small chance that PC could reoccur 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.
If the brace has been worn as directed by the physician and has been worn for at least two years without improvement, surgical intervention may be considered. At this time, the patient and his or her parents and the surgeon would discuss options and form a new plan of care.
Chest wall correction surgery
Surgical correction for pectus carinatum is a well-established and recognized option for treatment when bracing 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 will be made in the center of the chest to repair the abnormality. Post-operative drains will be in place for three to six days after surgery and will be removed when drainage decreases.
After a PC correction surgery, your child may be hospitalized for three to five days. He or she will be under strict activity restrictions for a minimum of two to three months after surgery.
Schedule an appointment
As the leading experts in the treatment and correction of chest wall deformities in Denver, patients travel from all over the Rocky Mountain region to receive care from The Chest Wall Deformity Correction and Bracing Clinic at RMHC.
To schedule an appointment with The Chest Wall Deformity Correction and Bracing Clinic at RMHC, please call (303) 839-6001.
Our chest wall clinic location
Our Chest Wall Deformity Correction Center and Bracing Clinic is located just minutes from Denver International Airport, one of the largest airports in the U.S. with nonstop flights to over 150 domestic destinations, making it the most accessible chest wall repair clinic offering the dynamic compression device in the country.