The Calgary protocol for bracing of pectus carinatum: a preliminary report

Compressive orthotic bracing in the treatment of pectus carinatum: the use of radiographic markers to predict success

“…One child stopped use of the brace during maintenance phase after excellent improvement and noted recurrence of the defect, which was successfully treated with resumption of bracing per protocol. As reported in other series, compliance is the key predictor of good outcome in these children with relatively simple deformities [9][10][11][12].…”

“…Drawing on their knowledge of the moldable nature of growing cartilage, Haje and colleagues [9] designed the first braces in Brazil in the early 1990s. Their success prompted further investigation into the most applicable mode of nonoperative therapy for pectus deformities and led to a number of reports of case series in which bracing was successfully used [6,[10][11][12].…”

“…At present, the available bracing techniques include a custom-fitted thoracic brace that was used in this series of patients or a lower profile brace with compression plates and aluminum struts as used in the Calgary and Cincinnati cohorts [11,12]. The geometrical alignment of maximal force on the point of most prominent protrusion is of utmost importance in either technique, and the bracing protocols are becoming more standardized.…”

Chest Wall Deformities: An Overview on Classification and Surgical Options

“…Recently, some modifications to the Ravitch and Welch procedure were proposed (Del Frari & Schwabegger, 2011;Fonkalsrud & Anselmo, 2004), attempting to reduce the invasiveness of this approach, by reducing the extent of muscle and cartilage resection. The best treatment for PC type 2 and Currarino Silverman syndrome remains the open procedure (Brichon & Wihlm, 2010), while the following alternatives, minimally invasive or conservative techniques, have been recently proposed for type 1 PC, with good results: -The orthotic brace system, proposed already in 1992 (Haje & Bowen, 1992) but popularized only recently by different groups approximately at the same time (Banever et al, 2006;Frey et al, 2006;Kravarusic et al, 2006;Rapuzzi et al, 2010, Swanson & Colombani, 2008, is based on the principle of reshaping the thorax during puberty due to thoracic malleability (as in Nuss procedure for PE) by applying a dynamic compression on it. Martinez-Ferro (Martinez-Ferro et al, 2008) added to this system the possibility to measure the pressure necessary to the correction and to regulate it (dynamic compression system, DCS).…”

Abordagem ortopédica das deformidades pectus: 32 anos de estudos

“…Órte-ses compressivas com velcros ou fechos nas laterais têm sido descritas como opções terapêuticas conservadoras efetivas para crianças com tipos flexíveis de pectus carinatum (27)(28)(29)(30)(31) . (19,23,32) .…”