Outcomes Following Dynamic Compression Bracing for Pectus Carinatum.

Creator(s)

Charlene Dekonenko, Children's Mercy Hospital
Robert M. Dorman, Children's Mercy Hospital
Amy L. Pierce, Children's Mercy HospitalFollow
Beth A. Orrick, Children's Mercy HospitalFollow
David Juang, Children's Mercy HospitalFollow
Pablo Aguayo, Children's Mercy HospitalFollow
Jason D. Fraser, Children's Mercy HospitalFollow
Tolulope A. Oyetunji MD MPH, Children's Mercy HospitalFollow
Charles L. Snyder, Children's Mercy HospitalFollow
Shawn D. St Peter, Children's Mercy HospitalFollow
G W. Holcomb III, Children's Mercy HospitalFollow

Document Type

Article

Publication Date

10-2019

Identifier

DOI: 10.1089/lap.2019.0171

Abstract

Introduction: Children with pectus carinatum (PC) are particularly vulnerable to psychosocial effects of poor body image, even though they may not experience physical symptoms. Nonoperative treatment with orthotic bracing is effective in PC correction. We describe our experience with dynamic compression bracing (DCB) for PC patients and their satisfaction with bracing.

Materials and Methods: Prospective institutional data of patients undergoing DCB from July 2011 to June 2018 were reviewed and analyzed for those who entered the retainer mode after correction, defined by a correction pressure of

Results: Of 460 PC patients, 144 reached the retainer mode. Median time to retainer mode was 5.5 months. There was no statistically significant relationship between initial correction pressure or carinatum height and time to retainer mode (P = .08 and P = .10, respectively). Fifty-seven percent were compliant with brace use, and median time to retainer mode in this subset was significantly shorter than noncompliant patients (3.5 months versus 10 months, P < .001). Fifty-three percent responded to the survey 13 months [interquartile ratios 3, 33] after the last clinic visit. The main barrier to compliance with wearing the brace was discomfort (37%), while the main motivation for compliance was appearance (58%). All endorsed bracing as worthwhile, with 94% reporting a satisfaction rating of 8 or greater for the correction outcome.

Conclusion: DCB is effective in achieving correction of PC in compliant patients. Regardless of time to retainer mode, patients reported high satisfaction with bracing.

Journal Title

Journal of laparoendoscopic & advanced surgical techniques. Part A

Volume

29

Issue

10

First Page

1223

Last Page

1227

MeSH Keywords

Adolescent; Braces; Child; Female; Follow-Up Studies; Humans; Male; Manipulation, Orthopedic; Patient Compliance; Patient Satisfaction; Pectus Carinatum; Pressure; Treatment Outcome

Keywords

dynamic compression bracing; pectus carinatum; pediatric chest deformity

Recommended Citation

Dekonenko C, Dorman RM, Pierce A, et al. Outcomes Following Dynamic Compression Bracing for Pectus Carinatum. J Laparoendosc Adv Surg Tech A. 2019;29(10):1223-1227. doi:10.1089/lap.2019.0171