Postural Alterations in Adolescents With Pectus Excavatum and Pectus Carinatum: A Retrospective Observational Study

BACKGROUND Pectus excavatum (PE) and pectus carinatum (PC) are the most common anterior chest wall deformities, affecting approximately 1% of the pediatric population. This study aimed to determine the prevalence of postural alterations in patients with PE and PC and to evaluate their associations with deformity type and severity. MATERIAL AND METHODS This retrospective, single-center descriptive study reviewed medical records of 268 patients aged 10-18 years who were evaluated for chest wall deformities between 2018 and 2024. Demographic variables, deformity type (PE, PC, or mixed), deformity severity (mild, moderate, severe), and postural findings (forward head posture, rounded shoulders, shoulder height asymmetry, thoracic kyphosis, scoliosis, increased or flat lumbar lordosis, anterior pelvic tilt), and New York Posture Scores (NYPS) were analyzed. RESULTS The mean age was 15.6±1.7 years, and 86.9% were male. Deformity distribution was 61.8% PE, 31.8% PC, and 6.4% mixed. Deformity severity increased with age (χ²=31.79; P=1.24×10⁻⁷). Postural disorders were highly prevalent: forward head posture (90.3%), rounded shoulders (81.7%), thoracic kyphosis (68.3%), and scoliosis (50.7%). PC patients showed significantly higher rates of kyphosis, scoliosis, shoulder asymmetry, and increased lumbar lordosis than PE patients (all P<0.05). CONCLUSIONS Postural alterations in PE and PC adolescents are widespread and multifactorial, indicating that chest wall deformities affect not only thoracic morphology but also axial skeletal alignment. These findings support the integration of systematic postural assessment and rehabilitation strategies into pectus management algorithms.