The Dynamic Compression Brace for Pectus Carinatum: Intermediate Results in 286 Patients

Ann Thorac Surg. 2017 Jun;103(6):1742-1749. doi: 10.1016/j.athoracsur.2016.12.019. Epub 2017 Mar 6.

Abstract

Background: Dynamic brace compression is a novel treatment for patients with pectus carinatum. The dynamic compression system contains a device to measure the flexibility of the thoracic wall and regulate the pressure of the brace.

Methods: Patients referred to our pediatric surgical center were screened for treatment with the dynamic compression brace. Patients with a pressure of initial correction (PIC) of 10.0 pounds per square inch or less were offered treatment with the brace. Patients with a PIC above 10.0 pounds per square inch were offered surgical correction. Between March 2013 and April 2016, 286 patients were treated with the brace; 260 were male (91%) and 26 were female (9%). Their mean age was 14 years (range, 4 to 21 years).

Results: Seventy-eight patients completed brace treatment; the mean treatment time was 14 months. Twenty-seven patients abandoned treatment because of lack of motivation, loss to follow-up, persistent protrusion of the sternal bone or flaring that required surgical correction, failure of treatment because of a bifid rib, fear of locking the brace, and delayed correction. One hundred eighty-one patients are still wearing the brace, either in the active or in the retainer phase. Patients with a high PIC also showed improvement when they were compliant. Adverse events were minor and included skin lesions (n = 4, 1%) and vasovagal reactions at the start of therapy (n = 3, 1%).

Conclusions: These data show that brace therapy can be considered a valuable treatment option to correct pectus carinatum in patients with a flexible thorax.

MeSH terms

  • Adolescent
  • Braces* / adverse effects
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Patient Compliance
  • Patient Satisfaction
  • Pectus Carinatum / psychology
  • Pectus Carinatum / therapy*
  • Young Adult