Brace compression for treatment of Pectus carinatum

kjtcs-45-396

Background.
Surgery has been the classical treatment of pectus carinatum (PC), though compressive orthotic braces have shown successful results in recent years. We propose a non-operative approach using a lightweight, patient-controlled dynamic chest-bracing device.
Materials and Methods
Eighteen patients with PC were treated between July 2008 and June 2009. The treatment involved fitting of the brace, which was worn for at least 20 hours per day for 6 months. Their degree of satisfaction (1, no correction; 4, remarkable correction) was measured at 12 months after the initiation of the treatment.
Fig. 3. These computed tomography scan images show three consecutive images taken from the same patient before, during, and after the recommended cycle of bracing treatment. A dramatic improvement in protrusion of chest wall is noted. (A) Before brace. (B) 2 months after brace. (C) 6 months after brace.

Fig. 3. These computed tomography scan images show three consecutive images taken from the same patient before, during, and after the recommended cycle of bracing treatment. A dramatic improvement in protrusion of chest wall is noted. (A) Before brace. (B) 2 months after brace. (C) 6 months after brace. Joonho Jung MD et al.

Results
Thirteen (72.2%) patients completed the treatment (mean time, 4.9±1.4 months). In patients who completed the treatment, the mean overall satisfaction score was 3.73±0.39. The mean satisfaction score was 4, and there was no recurrence of pectus carinatum in patients who underwent the treatment for at least 6 months. Minimal recurrence of pectus carinatum after removal of the compressive brace occurred in 5 (38.5%) patients who stopped wearing the compressive brace at 4 months.
Conclusion
Compressive bracing results in a significant improvement in PC appearance in patients with an immature skeleton. However, patient compliance and diligent follow-up appear to be paramount for the success of this method of treatment. We currently offer this approach as a first-line treatment for PC.

Brace Compression for Treatment of Pectus Carinatum, Joonho Jung MD, Sang Ho Chung RN, Jin Kyoung Cho RN, Soo-Jin Park MD, Ho Choi MD, and Sungsoo Lee MD. Korean J Thorac Cardiovasc Surg. 2012 Dec; 45(6): 396–400. doi: 10.5090/kjtcs.2012.45.6.396

Also see
How is Pectus Carinatum Treated? in Pediatric Education

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