Pectus Carinatum presents in different forms but there are consistent anomalies between them. Because there are different formations, only a custom bracing solution should be considered. In most cases there is a protrusion of some part of the sternum, a depression of the anterior ribs below the protrusion and then a flaring of the distal (lower) ribs. From a medical standpoint there are two types of pectus carinatum: chondrogladiolar prominence (CG) and chondromanubrial prominence (CM). With CG, the middle and lower areas of the rib cage arch forward. The longer, more flexible ribs are affected. With CM (rarer) the upper rib cage is affected. It is more difficult to treat because of the high location and because the affected ribs are shorter and less flexible. Pectus carinatum may also be classified by cause and time of onset. Those classifications include:

• post-surgical, which happens when the sternum doesn’t heal properly after surgery or chest trauma
• congenital, where premature fusion of the chest cavity is present at birth
• idiopathic, the most common type of PC, which usually appears between ages 7 and 15 and correlates with growth spurts
• adult, usually an untreated idiopathic PC

PC is also classified according to the severity of the deformity as either:

• Mild
• Moderate
• Severe

Mild cases may not require braces and if they do will correct very quickly. Moderate cases usually fully correct but often require a slightly longer wearing schedule. Severe cases require the longest time to correct and may not fully correct if the deformity has drifted to much to the side (Lateral PC). In reviewing hundreds of patients treated with the LA Pectus Brace Treatment Program (LAPBTP), we have classified Pectus Carinatum into seven categories based on the location of the primary prominence, as follows.