Success and duration of dynamic bracing for pectus carinatum: A four-year prospective study
Sherif Emil1, Marika Sévigny1, Kathleen Montpetit2
1Division of Pediatric General and Thoracic Surgery, The Montreal Children's Hospital, McGill University Health Centre; Chest Wall Anomaly Center, Shriners Hospital for Children, Montreal, Canada.
Background:
This study sought to establish factors that can prognosticate outcomes of bracing for pectus carinatum (PC).
Methods:
Prospective data were collected on all patients enrolled in a dynamic bracing protocol from July 2011 to July 2015. Pressure of correction (POC) was measured at initiation of treatment, and pressure of treatment (POT) was measured pre- and post-adjustment at every follow-up visit. Univariate and Cox regression analysis tested the following possible determinants of success and bracing duration: age, sex, symmetry, POC, and POT drop during the first two follow-up visits.
Results:
Of 114 patients, 64 (56%) succeeded, 33 (29%) were still in active bracing, and 17 (15%) failed or were lost to follow-up. In successful patients, active and maintenance bracing was 5.66±3.81 and 8.80±3.94months, respectively. Asymmetry and older age were significantly associated with failure. Multivariable Cox proportional hazard analysis of time-to-maintenance showed that asymmetry (p=0.01) and smaller first drop in POT (p=0.02) were associated with longer time to reach maintenance.
Conclusions:
Pressure of correction does not predict failure of bracing, but older age, asymmetry, and smaller first drop in pressure of treatment are associated with failure and longer bracing duration.
Level Of Evidence:
Prospective Study/Level of Evidence IV.
More Related Videos
07:02A Large Animal Model for Pulmonary Hypertension and Right Ventricular Failure: Left Pulmonary Artery Ligation and Progressive Main Pulmonary Artery Banding in Sheep
Published on: July 15, 2021
07:01Clinical Efficacy of Ultrasound-Assisted Scoliosis-Specific Exercise in Mild-Grade Adolescent Idiopathic Scoliosis
Published on: December 2, 2025
Related Concept Videos
01:26Flail Chest-II
Assessment:
1. Clinical Evaluation:
History:
01:17The Thoracic Cage: Sternum
The sternum is the elongated bony structure on the anterior side of the thoracic cage. It consists of three parts: the manubrium, the body, and the xiphoid...
01:20The Thoracic Cage: Ribs
Parts of a Typical Rib
A typical rib has a head, neck, and body. The posterior end of the rib is called the head, followed by a narrow neck. The head articulates primarily with the costal...
01:27Pneumothorax-II
Clinical Manifestations:
01:25Muscles of the Thorax
The diaphragm is at the core of thoracic musculature, the primary muscle involved in breathing. This expansive, dome-shaped muscle marks the division between the thoracic and abdominal cavities. It...
01:24Flail Chest-I
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...