Current Status and Progress in the Treatment of Pectus Carinatum

Pectus carinatum (PC) is a common congenital anterior chest wall deformity characterized by protrusion of the sternum and costal cartilages. It may be associated with mild cardiopulmonary functional impairment and substantial psychological distress. Diagnosis is primarily based on visual inspection and physical examination, supplemented by objective, quantitative imaging assessment—including anteroposterior and lateral chest radiography, multi-slice spiral computed tomography (CT), and three-dimensional (3D) reconstruction. For patients in the growth phase with a flexible chest wall, dynamic compression bracing (DCB) is the first-line conservative treatment; its efficacy is highly dependent on measurable, titratable pressure application and rigorous adherence management. Remote monitoring tools have been increasingly employed to objectively document brace-wearing behavior and support longitudinal follow-up. Surgical intervention is considered in cases of brace failure, chest wall rigidity, or severe deformity. Surgical approaches have evolved from traditional open procedures (e.g., Ravitch procedure and its modifications) toward minimally invasive techniques centered on sustained external force remodeling—such as the Abramson technique, Wenlin procedure, and their combined strategies—emphasizing individualized, phenotype-driven treatment planning. This review summarizes current evidence on the etiopathogenesis, diagnostic classification, clinical manifestations, and advances in both conservative and surgical management of PC.