Chest Wall Disorders

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Chest Wall Disorders

Experts in Disorders of the Ribs & Breastbone

Nemours physician helps a young boy with a chest wall disorder.

Nemours’ pediatric surgeons are skilled in diagnosing, treating and managing chest wall disorders of the ribs and breastbone (sternum). More commonly found in boys, chest wall disorders are sometimes called “chest wall deformities” or “chest wall malformations.” They can range from mild to serious. Some children may only need a brace to correct the problem. If the condition is more noticeable and causes other health issues, kids may need surgery. At Nemours, our goal is to help children feel better, inside and out.

Learn more about:

Pectus Carinatum
Pectus Excavatum

Conditions We Treat

Conditions We Treat

We treat these chest wall disorders:

  • pectus carinatum (sometimes called "protruding chest" or "pigeon chest") — when the chest pushes out. Pectus carinatum usually isn’t noticeable until around 11 years old. Kids with pectus carinatum may feel tired and have shortness of breath, a fast heartbeat, chest pain and/or asthma.
  • pectus excavatum (sometimes called "sunken chest" or "funnel chest") — when the chest is caved in. Pectus excavatum may not show up for the child’s first few years or until their teens. Symptoms may include feeling tired, having a hard time with physical activity, chest pain, coughing, fast heartbeat and chest infections.

Sometimes, kids have pectus carinatum on one side of the chest, and pectus excavatum on the other.

Services We Offer

Services We Offer

Many options are available when it comes to treating chest wall deformities. The key is to get an evaluation as early as possible. This allows your family to better:

  • understand your child’s condition and how it affects or could affect the heart and lungs, if at all
  • prepare for potential physical and social impacts
  • learn which surgical procedures and treatment options are available to manage your child’s condition
  • make sure your child is treated at the right time during their skeletal development (it varies from child to child)
  • explore nonsurgical (without surgery) management options

We offer complete chest wall disorder services, which may be different based on the condition and location:

Surgery Options

  • Nuss procedure — an operation to correct pectus excavatum. This operation is usually performed in children 13 to 20 years old. The surgeon makes the smallest possible cuts in order to place a bar in the chest. After three years, the surgeon removes the bar, which acts as a sort of internal brace to push the chest forward.
  • Ravitch procedure — an operation to correct pectus carinatum or pectus excavatum. This operation is usually performed in kids ages 8 years old and up. The surgeon makes a cut across the chest to reshape the breastbone and ribs. 

Nonsurgery Options

  • bracing — a treatment for pectus carinatum. A lightweight brace wraps around the chest. Similar to braces for teeth, the brace pushes the chest bone into a normal position over time (usually for at least six months).
  • vacuum bell device — a procedure for pectus excavatum. This plastic, bell-shaped device connects to a pump. You place the device on the front of the chest and use the pump to suck the air out of the device. This creates a vacuum that pulls the chest forward. Over time, the chest wall stays forward on its own. Kids usually wear the device twice a day for at least a year.

Physical Therapy

Why Choose Us

Why Choose Us

If your child has a chest wall disorder, you can count on our highly skilled board-certified pediatric surgeons and care teams. Year after year, many of our surgeons are named as “Best Doctors in America®,” and “Top Doctors” by local magazines in our areas. And, as a leader in surgical outcomes and overall quality of care, Nemours is involved in a nationwide effort to improve pediatric surgical care.

When appropriate, we also offer minimally invasive surgery (operations with smaller incisions resulting in faster healing). Nemours also has extensive physical medicine and rehabilitation services available on-site that are staffed by experienced experts trained to work with children with chest wall disorders.

Regional Chest Wall Disorder Highlights

Services, programs and care teams differ at each location. Call for details.

We offer chest wall disorders care at Nemours/Alfred I. duPont Hospital for Children (Wilmington, Del.).

We offer chest wall disorders care at Nemours Children’s Hospital (Orlando).

We offer chest wall disorders care at Nemours Children’s Specialty Care, Jacksonville (in collaboration with Wolfson Children’s Hospital).

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Scheduled Specialist Online Visits

Nemours now offers scheduled specialist appointments through live video chat. Ask your doctor if this is an option for your family.

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Research & Clinical Trials

At Nemours, we’re actively researching new approaches for childhood disease prevention, diagnosis and treatment.

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KidsHealth Library

Learn more about your child’s medical condition from the experts at Nemours’ KidsHealth.