Thorac Cardiovasc Surg 2020; 68(01): 072-079
DOI: 10.1055/s-0039-1687824
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Effectiveness of Compressive External Bracing in Patients with Flexible Pectus Carinatum Deformity: A Review

Ian Hunt
1  Department of Thoracic Surgery, St. George’s Hospital, London, United Kingdom
Akshay Jatin Patel
2  Institute of Immunology and Immunotherapy, University of Birmingham, United Kingdom
› Author Affiliations
Further Information

Publication History

09 January 2019

12 March 2019

Publication Date:
25 April 2019 (online)


There has been a growing interest in the nonoperative treatment of chest wall deformities over the last few decades; with the advent of external compressive orthotics, similar outcomes have been reported compared with surgical intervention. There have been fewer major complications reported with dynamic compression bracing on the chest wall; however, the Achilles heel of this approach still lies with treatment tolerability and compliance. A Medline literature search was undertaken to evaluate the evidence concerning the techniques, modifications, and outcomes associated with external compressive bracing in the setting of pectus carinatum. Sixteen articles were integrated after literature review and data were collected on methods of assessing pectus carinatum (degree of severity as well as type), patient selection protocol (i.e., suitability for external compressive bracing), the bracing protocol itself, duration of treatment, metrics used to assess outcome, and success, compliance, and dropout rate, and length of long-term follow-up. Compressive external bracing appears to be a safe and well tolerated nonsurgical treatment option for young patients with flexible pectus carinatum deformities. However, there is still a need for robust level I randomized data from multiple centers with a clearly standardized bracing protocol, objective measurement of outcomes, and recording of results at the end of the bracing treatment program in sufficiently powered sample sizes over a significant follow-up period.


There were no funding sources used to support this study. All the authors had the freedom of investigation and full control of the design of this study including methods used, decision on outcome parameters, results, data analysis, and production of the written report. No grants or financial support was sought for this project and in the construction of this manuscript.