How orthosis wear time affects pectus carinatum outcomes

A study in the Journal of Prosthetics and Orthotics found that wearing a pectus carinatum orthosis at least 16 hours a day was associated with the greatest improvement in the deformity. The retrospective study also found that Pectus carinatum deformity worsens when the orthosis is worn minimally or not at all.

SmartBrief Spotlight on O&P Dec 16, 2025

Abstract

Background

Pectus carinatum compression orthoses are an effective treatment for pectus carinatum when the prescribed wear-time protocol is well adhered to. There is limited information on treatment outcomes when the daily wear-time protocol is not closely followed.

Objective

This study aims to assess the impact of patient-reported average daily wear time on pectus carinatum treatment outcomes.

Study Design

This is a retrospective cohort study of patients treated for pectus carinatum with a pectus carinatum orthosis.

Methods

We reviewed the medical records of 67 patients with pectus carinatum who were treated with a pectus carinatum orthosis. At each follow-up visit, we assessed patient-reported wear time and categorized each treatment interval between visits into one of four categories: fulltime wear (16+ hours), partial wear (8–15 hours), minimal wear (2–7 hours), and not wearing (0–1 hours). We used a multivariable linear mixed effects model to evaluate changes in chest anteriorposterior dimension by wear-time categories.

Results

Average improvement in pectus carinatum deformity was greatest during full-time wear visit intervals (−0.88 cm). Full-time wear visit intervals produced significantly greater improvement in deformity than all other categories (partial wear: P = 0.036; minimal wear: P < 0.0001; not wearing: P = 0.0003). Improvement in deformity decreased as average daily wear time decreased. Pectus carinatum deformity worsened during visit intervals in which the pectus carinatum orthosis was worn minimally (0.15 cm) or not at all (0.93 cm).

Conclusions

Average daily wear time significantly impacts outcomes in pectus carinatum orthotic treatment. Patient-reported daily wear time of 16 hours or greater produced the greatest improvement in deformity.

Clinical relevance

This study helps clinicians provide patients and families with detailed information regarding the effects of daily wear time on successful orthotic management of pectus carinatum.

Source SmartBrief Spotlight on O&P

References

Effect of Orthosis Daily Wear Time on Pectus Carinatum Treatment Outcomes, Patrick, Natalie W. MSPO, CPO; Mincone, Hollie R. MSPO, CO; Vallery, Claire E. MPO, CPO; Kemper, Amanda T. MPO; Yosef, Matheos PhD; Khalatbari, Shokoufeh H. MS; Frank, Christopher J. MD, PhD; Richards, Jennifer A. MA, CPO. Journal of Prosthetics and Orthotics 38(1):p 21-26, January 2026. | DOI: 10.1097/JPO.0000000000000567