Does Pectus Carinatum Affect Height?

Pectus carinatum can cause a wide range of symptoms, from poor posture and fatigue to asthma-like symptoms. If your child suffers from pectus carinatum, these can be quite worrying. On the positive side, most of the impacts of pectus carinatum can be effectively treated, meaning that most children with pectus carinatum can lead a normal and healthy life without requiring surgical intervention. However, you may still have some worries about whether pectus carinatum will stunt your child’s growth. This article will summarize the current research on the relationship between pectus carinatum and growth to provide you with the most up-to-date information. 

What Is Pigeon Chest?

Pectus carinatum, also known as "pigeon chest," is a congenital condition characterized by an outward protrusion of the breastbone. This appears to arise due to a combination of genetic and environmental factors, which make an individual susceptible to overgrowth of the breastbone cartilage, which usually becomes prominent during the early pre-teen to teenage years. It is a moderately rare condition, affecting around 1 in every 1,500 births.[1] It is much more common in males, with around 4—5 times more cases seen in boys compared to girls.[2,3] 

Pigeon chest can occur in isolation, or it may develop as a result of other conditions such as Noonan syndrome, osteogenesis imperfecta, trisomy 18, trisomy 21 (Down syndrome), or Marfan syndrome, amongst others. 

In addition to the protrusion of the breastbone, pigeon chest can cause a range of other issues, including: 

• Fatigue and shortness of breath
• Rib flare
• Curving of the spine
• Rounding of the shoulders
• Hunching of the back
• Rarely, chest pain or an increased heart rate

However, the impact of pectus carinatum on a child’s physical development and height is not commonly discussed. 

Does Pectus Carinatum Affect Height Growth?

As mentioned, very few studies have investigated the relationship between pectus carinatum and height. However, one study by Desai and co-workers, presented at the Academic Surgical Congress, found that patients with a congenital chest wall deformity (including both pectus carinatum and pectus excavatum) had an average height higher than unaffected children.[4] However, their weight was similar to average, giving children with a chest wall deformity a lower BMI (body mass index). 

Similarly, another study reported a lower BMI in children with pectus carinatum compared to a healthy control group[5], with a mean BMI of 17.5 compared to 20.7. This study also noted that pectus carinatum patients had lower grip strength, which may be related to connective tissue problems. 

Why Are Children With Pectus Carinatum Typically Taller Than Unaffected Children?

Although the reason for increased height in children with pectus carinatum is not well understood, it likely arises from associated skeletal or connective tissue abnormalities. A moderate proportion of pectus carinatum cases are caused by other syndromes, such as Marfan syndrome — a genetic connective tissue disorder. The connective tissue is looser than in most people, meaning that the skeleton can expand further than usual during the growth stage in puberty. In addition, the defective gene responsible also causes some bones to grow longer than they normally do, resulting in most children with this syndrome reaching the 99th percentile for height. 

Another factor that may influence height in children with pectus carinatum is poor posture or hunched shoulders, which may reduce their height (or at least their apparent height). 

Consequently, the increased average height seen among children with pectus carinatum may not be caused explicitly by pectus carinatum but due to other associated factors. However, further investigation into this relationship by researchers is needed. 

What You Can Do to Help Your Child

Untreated pectus carinatum can negatively impact your child’s quality of life. This includes not just the physical problems mentioned throughout this article but also its psychological impacts. However, the good news is that pectus carinatum can be effectively treated in most people without requiring invasive surgery.

Nearly all studies recommend non-surgical treatment with an orthotic brace as the first line of treatment for most patients with pectus carinatum.[6] An orthotic pectus brace is a compression brace that applies pressure to the protruding breastbone region, which helps remodel the growth of the cartilage forming the breastbone, eventually molding the breastbone into the desired shape.[6] Consequently, the most effective results are obtained when bracing treatment is started in the early pre-teen to teenage years, while the breastbone cartilage is still pliable and compliant. In addition, the brace must be worn for an extended period to obtain successful results. In most patients, this will be for up to 22 hours per day, for around 6–12 months. 

Although this may seem like a significant hassle, it is much less painful and less risky than invasive surgical procedures. Furthermore, most patients will see very positive results from orthotic bracing treatment, with more than 90% of treated patients obtaining a successful outcome. Once the full bracing program has been completed, recurrence of the condition is very rare. The most important factor for successful treatment is compliance — that is, wearing the brace worn as prescribed by your treating health professional.

This is where Custom Pectus Brace from Dakota Brace can help. For each of our braces, we use a 3D scan of your child’s chest to design a custom-fitted brace that perfectly matches your child’s body shape and condition (e.g., pectus carinatum in isolation or pectus carinatum with rib flare).

We use the latest 3D-printing technology to ensure a great fit while minimizing production times. Furthermore, all the steps can be performed remotely,* meaning we can work around your schedule. 

*Note: You will need access to an iPhone X or later to do your initial scan. 

Conclusion

Does your child suffer from pectus carinatum? Here at Dakota Brace, we aim to provide the best possible treatment for pectus carinatum at an affordable cost. Arrange a free consultation with one of our health professionals and $75 off your first order!

References

1. Robicsek F, Watts LT. Pectus carinatum. Thorac Surg Clin. 2010;20:563–74.
2. Cobben, J. M., Oostra, R. J., & van Dijk, F. S. (2014). Pectus excavatum and carinatum. European Journal of Medical Genetics, 57(8), 414-417.
3. Abdullah F, Harris J (2016) Pectus excavatum: more than a matter of aesthetics. Pediatr Ann, 45:e403–e406.
4. Desai A. A., Alemayehu, H., Dalton, B. G., Schnell, K. W., St. Peter, S. D., & Snyder, C. L. (2014). Increased height associated with patients with pectus excavatum and pectus carinatum. Presented at the 2014 Academic Surgical Congress. https://www.asc-abstracts.org/abstracts/13-19-increased-height-associated-with-patients-with-pectus-excavatum-and-pectus-carinatum/ 
5. Alaca, N., & Yüksel, M. (2021). Comparison of physical functions and psychosocial conditions between adolescents with pectus excavatum, pectus carinatum and healthy controls. Pediatric Surgery International, 37, 765-775.
6. Lee, R. T., Moorman, S., Schneider, M., & Sigalet, D. L. (2013). Bracing is an effective therapy for pectus carinatum: interim results. Journal of Pediatric Surgery, 48(1), 184-190.