Causes of Pectus Deformities
There is no unified opinion on causation, but there is evidence to suggest that both pectus excavatum and pectus carinatum can be inherited conditions.
We are indebted to the late Dr Haje for the information that follows. Dr Haje was widely regarded as the world's leading authority on the non-surgical treatment of pectus deformities. We have summarised his audit of the 4,346 patients he treated.
The sample of Dr Haje's patients consisted of:
- 73% male - 27% female
- 77% carinatum - 23% excavatum
In terms of etiology, 22 had a surgical cause, while 13 had a pathological cause. Thus, 4,311 of his patients had no obvious cause for their condition. Dr Haje's further classification revealed that 50% had a biomechanical factor that seemed to coincide with the onset of the condition. These included respiratory disturbances, such as asthma and bronchitis. Some 47% had inherited their condition. In the group as a whole, he also found a high degree of spinal deformities: 47% presented with scoliosis and 14% had a degree of hyper kyphosis.
During his analysis, Dr Haje discovered that the chest has growth plates, rather than sutures similar to those found in the skull, as was the conventional understanding. The growth plates are why bracing treatment can remodel chests. Rapid growth, as in puberty, is key to how the chest develops. Most of our patients complain that their condition got a lot worse during periods of rapid growth. It is important to harness this period for treatment, in order to achieve better and faster results. Equally, it must be understood that any existing condition is likely to get worse during periods of growth, unless treated.
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