Staged management of pectus carinatum
Amy S Cohee1, James R Lin, Frazier W Frantz
1Children's Hospital of The King's Daughters, Norfolk, VA 23507, USA.
Journal of Pediatric Surgery
|February 19, 2013
Summary
This study evaluated a new Argentine brace for pectus carinatum, finding non-operative treatment successful for most teenagers. Minimally invasive surgery is a viable option for those not responding to bracing.
Area of Science:
- Thoracic surgery
- Pediatric surgery
- Orthopedics
Background:
- Pectus carinatum is a chest wall deformity affecting adolescents.
- Traditional treatments include bracing and open surgery.
- Novel bracing and surgical techniques are being explored.
Purpose of the Study:
- To report the outcomes of treating pectus carinatum using a novel Argentine brace.
- To evaluate the efficacy of minimally invasive surgery for cases refractory to bracing.
Main Methods:
- A retrospective review of 137 pectus carinatum patients treated with an Argentine brace between 2008 and 2011.
- Analysis of bracing adherence, treatment success, failure rates, and complications.
- Evaluation of surgical outcomes for patients who failed conservative management.
Main Results:
- 55% of patients progressed with active bracing treatment.
- 30% achieved sternal flattening without surgery, followed by a retainer phase.
- Minimally invasive surgery (Abramson repair) and open repair showed good initial correction for surgical candidates.
Conclusions:
- Staged, non-operative treatment with the Argentine brace is effective for the majority of adolescent pectus carinatum cases.
- Minimally invasive surgical options provide a viable alternative for patients unsuitable for or failing bracing.
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