Bracing of pectus carinatum: A quantitative analysis

Area of Science:

• Orthopedics
• Biomechanical Engineering
• Pediatric Surgery

Background:

• Pectus carinatum (PC) treatment commonly involves external bracing to compress the chest protrusion.
• Prescribed brace tightening force is essential, yet lacks visual guidance for patients.
• Variability in patient-applied force may impact treatment efficacy.

Purpose of the Study:

• To assess the repeatability of patients applying their prescribed brace force over time.
• To investigate the influence of protrusion stiffness on patient-applied forces.
• To determine if protrusion stiffness affects the rate of chest protrusion correction.

Main Methods:

• A cohort of 21 male participants (12-17 years) with chondrogladiolar PC was studied.
• Data were collected at brace fitting, one month, and two months postfitting.
• Patient-applied forces were compared to prescribed forces, and relationships with protrusion stiffness were analyzed.

Main Results:

• A significant difference between patient-applied and prescribed forces was observed in 75% of individuals over two months (p<0.05).
• Protrusion stiffness positively correlated with patient-applied force.
• Protrusion stiffness did not show a relationship with the correction rate.

Conclusions:

• Patients demonstrated inconsistency in applying prescribed brace forces.
• The clinical significance of force discrepancies warrants further investigation.
• While protrusion stiffness influences applied force, it does not predict correction rate, suggesting other factors like patient compliance are critical.