Bracing in pediatric patients with pectus carinatum is effective and improves quality of life

PURPOSE
The purpose of this study was to examine the effectiveness and patient satisfaction with bracing for pectus carinatum (PC).
MATERIALS AND METHODS
Twenty-five PC patients were treated between August 2007 and October 2011. Most patients were male (21/25,84%) with a mean age of 14.4 ± 2.0 yrs. A lightweight, patient controlled, external brace (Braceworks, Calgary, AB) was used. Monthly follow-up with anterior-posterior (AP) width measurements occurred until bracing was completed. Three quality of life (QOL) questionnaires were used: SF-36, SSQ, and PEEQ.
RESULTS
Group 1 involved twenty patients who successfully completed bracing (12/25,56%) or who are still bracing (8/25,32%). Group 2 comprised five patients who failed bracing (2/25,8%) or who were noncompliant (3/25,12%). One patient who failed bracing underwent successful Ravitch repair. AP width decreased more in those with successful bracing (2.31 vs 0.64 cm, p=0.05). Questionnaires were completed by 19/25 (76%) patients. Pre-bracing, the SF-36, and PEEQ revealed that few patients were symptomatic, although most still avoided activities which showed their chest. The SSQ revealed that the majority of patients were very satisfied with their post-bracing appearance, experienced minimal discomfort while bracing, and would use the brace again. Self-esteem increased significantly after bracing (7.5 vs 8.7, p=0.01).
CONCLUSIONS
Bracing in PC patients is very effective in a compliant patient with close follow-up. Surgical repair remains feasible if bracing fails.

Bracing in pediatric patients with pectus carinatum is effective and improves quality of life, Colozza S, Bütter A. Division of Pediatric Surgery, Children’s Hospital, The University of Western Ontario, London, Ontario, Canada. Journal of Pediatric Surgery. 2013 May;48(5):1055-9. doi: 10.1016/j.jpedsurg.2013.02.028.

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