Nonoperative correction of pectus carinatum with orthotic bracing

Abstract

Background: This study sought to evaluate the efficacy of nonoperative compression in correcting pectus carinatum in children.

Materials and methods: Children presenting with pectus carinatum between August 1999 and January 2004 were prospectively enrolled in this study. The management protocol included custom compressive bracing, strengthening exercises, and frequent clinical follow-up.

Results: There were 30 children seen for evaluation. Their mean age was 13 years (range, 3-16 years) and there were 26 boys and 4 girls. Of the 30 original patients, 6 never returned to obtain the brace, leaving 24 patients in the study. Another 4 subjects were lost to follow-up. For the remaining 20 patients who have either completed treatment or continue in the study, the mean duration of bracing was 16 months, involving an average of 3 follow-up visits and 2 brace adjustments. Five of these patients had little or no improvement due to either too short a follow-up or noncompliance with the bracing. The other 15 patients (75%) had a significant to complete correction. There were no complications encountered during the study period.

Conclusion: Compressive orthotic bracing is a safe and effective alternative to both invasive surgical correction and no treatment for pectus carinatum in children. Compliance is critical to the success of this management strategy.