East Anglia Pectus and Chest Wall Services
How We Can Help
Pectus Carinatum Pigeon Chest
Pectus carinatum – Brace treatment
Non-surgical treatment with the brace represents one of the most common and effective techniques to treat pectus carinatum.
This is accomplished by a specially fitted compression brace around the circumference of the chest that applies the correct pressure to reshape the chest and decrease the bony protrusion.
The success of bracing therapy is directly related to the elasticity of the chest wall and the number of hours per day the patient applies the brace.
We recommend you wear the brace for several hours per day and for a duration of about a year.
We will regularly, in the outpatient clinic, evaluate the progression of the treatment and adjust the bracing pressure as necessary.
We offer different type of braces for the management of the pectus carinatum including the most advanced FMF Dynamic Compressor.
The major advantage of this bracing system is that it objectively measures the pressure needed to correct the condition.
Bracing treatment for pectus carinatum is very safe.
Pectus Carinatum – Surgery
Surgery for pectus carinatum is an option for patients that have reached adulthood and there is no chest elasticity, making the brace treatment is ineffective.
The modified Ravitch procedure is a surgical operation that involves removing the abnormal cartilages and placing the breastbone in a normal position within the chest. The procedure is performed with general anaesthesia through a vertical midline incision just on top of the deformity. In some cases, the surgeon will need to break the breastbone so that they can reposition it accurately most of the times using a metal plate. The result following the procedure is usually very good and following a hospital stay of 4-5 days the patient can be discharged home.
Contact us now to arrange for a consultation and discuss further the surgical management of pectus carinatum.
Pectus Excavatum
Pectus Excavatum – Vacuum Bell
The Vacuum Bell is a non-surgical treatment option for the management of pectus excavatum.
The Vacuum Bell uses a suction cup that creates a vacuum seal on the chest wall and lifts the sternum improving the deformity. The device allows patients to use it without interfering with school, sports and other daily activities.
Various studies have shown that Vacuum is a safe therapy for treating pectus excavatum in a non-surgical conservative manner. VBT has been shown to have higher success rates in those who present earlier, have mild, symmetric pectus excavatum, a more compliant chest wall and lack of costal flaring.
Contact us now to arrange for a consultation and discuss further the management of pectus excavatum with the vacuum bell.
Pectus Excavatum – Surgery
There are two types of surgical correction, both done under general anaesthesia, open repair (Ravitch Procedure) and minimally invasive repair with a metal bar (Nuss Procedure), both associated with very good results.
The majority of the patients with pectus excavatum are candidates for the Nuss procedure. However, the decision for the patient to undergo a Ravitch or Nuss procedure will depend on the degree of the pectus deformity, the age and lifestyle of the patient and the risks of each procedure.
The Ravitch procedure is performed through a midline incision. During this repair, the abnormal costal cartilages are removed, preserving the lining of cartilage, and the sternum is moved forward in a normal position. In some patients, an osteotomy (a break) in the sternum is done to allow the sternum to be positioned forward and that can be supported with the use of a biosynthetic mesh behind the sternum.
The Nuss Procedure involves the insertion of a stainless-steel bar under the sternum, to push the sternum forward into the correct position. Two incisions are performed on the lateral side of the chest for the insertion of the bar. The bar will stay in for 2-3 years and then it will be removed.
Rib Injury / Rib Fracture
Unlike sports or orthopaedic clinics, we specialise in ribs and chest wall injuries and problems exclusively.
The Rib Injury Clinic is led by Mr Kunal Bhakhri, a consultant Thoracic Surgeon who works with other specialists to offer the latest surgical and non-surgical treatments for all types of rib, chest wall and breastbone injuries and problems.
- Sternal fracture (breastbone)
- Xiphoid process pain
- Chronic chest wall pain
- Rib tumours
- Cervical extra ribs
- Thoracic outlet syndrome
- Slipping rib syndrome (clicking rib, displaced ribs, rib tip syndrome, nerve nipping, painful rib syndrome, and interchondral subluxation)
- Costochondritis/ Tietze syndrome