Nonoperative correction of pectus carinatum with orthotic bracing
Gregory T Banever1, Stanley H Konefal, Kim Gettens
1Division of Pediatric Surgery, Shriners Hospital for Children, Baystate Medical Center, Tufts University School of Medicine, Springfield, Massachusetts 01103, USA.
Insights
Nonoperative compression using custom orthotic bracing effectively corrects pectus carinatum in children. Patient compliance is crucial for successful outcomes with this safe, non-invasive treatment.
Area of Science:
- Pediatric Orthopedics
- Thoracic Surgery
- Biomechanical Engineering
Background:
- Pectus carinatum, a chest wall deformity, affects children.
- Nonoperative management strategies are being explored for pectus carinatum.
Purpose of the Study:
- To evaluate the efficacy of nonoperative compression in correcting pectus carinatum in pediatric patients.
- To assess the safety and effectiveness of custom compressive bracing for pectus carinatum.
Main Methods:
- Prospective enrollment of children with pectus carinatum (August 1999 - January 2004).
- Management protocol included custom compressive bracing, strengthening exercises, and frequent clinical follow-up.
- Evaluation of treatment outcomes and complications.
Main Results:
- 20 patients completed treatment or continued in the study, with a mean bracing duration of 16 months.
- 15 out of 20 patients (75%) achieved significant to complete correction of pectus carinatum.
- No complications were encountered during the study period.
Conclusions:
- Compressive orthotic bracing is a safe and effective nonoperative treatment for pediatric pectus carinatum.
- Bracing offers an alternative to surgical correction or no treatment.
- Patient compliance is critical for successful outcomes in pectus carinatum management.
Background:
This study sought to evaluate the efficacy of nonoperative compression in correcting pectus carinatum in children.
Materials And Methods:
Children presenting with pectus carinatum between August 1999 and January 2004 were prospectively enrolled in this study. The management protocol included custom compressive bracing, strengthening exercises, and frequent clinical follow-up.
Results:
There were 30 children seen for evaluation. Their mean age was 13 years (range, 3-16 years) and there were 26 boys and 4 girls. Of the 30 original patients, 6 never returned to obtain the brace, leaving 24 patients in the study. Another 4 subjects were lost to follow-up. For the remaining 20 patients who have either completed treatment or continue in the study, the mean duration of bracing was 16 months, involving an average of 3 follow-up visits and 2 brace adjustments. Five of these patients had little or no improvement due to either too short a follow-up or noncompliance with the bracing. The other 15 patients (75%) had a significant to complete correction. There were no complications encountered during the study period.
Conclusion:
Compressive orthotic bracing is a safe and effective alternative to both invasive surgical correction and no treatment for pectus carinatum in children. Compliance is critical to the success of this management strategy.
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