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Effect of the compressive brace in pectus carinatum

Department of Thoracic & Cardiovascular Surgery, Soonchunhyang University Cheonan Hospital, 23 Bongmyung-dong, Cheonan-city, South Korea

Received 12 February 2008; received in revised form 4 April 2008; accepted 14 April 2008.

^_* Corresponding author. Tel.: +82 41 570 2193; fax: +82 41 575 9674. (Email: csdoctor{at}korea.com).

Background: Patients with pectus carinatum complain of cosmetic problems because they stand out in spite of wearing clothes. Surgical treatment of pectus carinatum is resection of the deformed cartilage but a wide operative scar, postoperative pain and complications related with the operation can occur. Therefore we have performed compressive brace therapy as a non-operative treatment of pectus carinatum, and observed the effects and the efficiency of this treatment. Materials and methods: From January 2001 to December 2007, 119 patients with pectus carinatum were treated with a compressive brace that they wore for 24 h each day. Their degree of satisfaction was measured after 6 months wearing. This was evaluated with a score of 1–4. A score of 1 was assigned when the status was worse, 2 when it was same, 3 when partially improved, and 4 when a remarkable improvement was observed. Satisfaction was assessed subjectively by a parent if the patient was a child, and patients older than middle school age assessed the score themselves. Results: The mean overall satisfaction score was 3.95 ± 0.4. Recurrence of pectus carinatum after removal of the compressive brace occurred in 6 (5.0%) of the total 119 patients. Four of these six patients stopped wearing the compressive brace against our advice. These six patients were re-corrected by re-wearing the compressive brace within 3 months after they originally removed it. Complications were discomfort at initial wearing of the brace, which occurred in all patients, skin rash due to compression for 84 patients (70.6%) and skin discoloration due to excessive compression for 18 patients (15.1%). The skin rash and discoloration disappeared within a few months after removal of the brace. Conclusion: This study demonstrated that non-surgical treatment using a compressive brace in patients with pectus carinatum was effective, especially in children and teenagers. Non-surgical treatment using a compressive brace in patients with pectus carinatum would be helpful for those who dislike surgery because of their fear about general anesthesia and operative complications. But, long-term follow-up is necessary to evaluate the effectiveness of this compressive brace and the recurrence of the condition after its removal.

Key Words: Pectus carinatum • Chest deformity • Compressive brace