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

Abstract

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

Pectus carinatum: When less is more

“…De Beer et al [52] validated the use of PIC to predict the duration of treatment, and Poola et al [51] found that a low PIC at the beginning of treatment was a good prognostic factor. In 2018, de Beer et al [50] published a systematic review of the measured dynamic compression system. They found 14 studies published between 2008 and 2018, and selected 8 for further analysis.…”

Current Options for the Treatment of Pectus Carinatum: When to Brace and When to Operate?

“…24,27 Pressure of correction did not show a correlation with success or bracing duration, again reinforcing results from other recent studies of the DCS brace. [17][18][19][20][21] The initial findings by Martinez-Ferro et al of a high failure rate with pressure of correction higher than 7.5 psi have not been duplicated in the more recent studies. 4,[17][18][19][20][21] There is therefore no pressure of correction threshold that can be considered a contraindication for bracing.…”

“…Most studies of bracing have identified lack of compliance as the main cause of failure. [16][17][18][19][20][21][22][23][24][25][26][27] Two recent studies have specifically looked into the issue of compliance. 25,29 Pessanha et al found that patients were likely to be noncompliant with duration rather than frequency of brace wear, that is, they wore the brace daily, but for shorter periods than prescribed.…”

“…Like many, we have preferred the DCS brace for three reasons. 4,[17][18][19][20][21] First, it provides objective pressure measurements as explained above. Second, its design allows for lateral expansion of the chest wall which occurs with successful anteroposterior compression.…”

Deformidad de la caja torácica

“…Tiende a ser la primera línea de tratamiento, especialmente en pacientes que tienen una pared torácica maleable y sean menores de dieciocho años. Se han reportado una tasa de éxito de 65% a 80% con buenos resultados a largo plazo usando este tratamiento 43,44 (Figura 5).…”