Bracing of Pectus Carinatum in Children: Current Practices

TL;DR

This study examines how doctors currently use bracing to treat pectus carinatum in children and finds that while bracing is effective, practices vary and need standardization.

Contribution

The study provides a global overview of bracing practices for pectus carinatum among specialists and highlights the need for standardized treatment protocols.

Findings

93% of respondents use bracing as the first-line treatment for pectus carinatum.

Dynamic compression systems show faster response times compared to conventional braces.

High recurrence rates (up to 30%) are observed during puberty, emphasizing the need for extended follow-up.

Abstract

Background: Although effective, compressive orthotic bracing (COB) in children with pectus carinatum is still not standardized. This study has aimed to analyze current practices amongst members of the Chest Wall International Group (CWIG). Methods: A web-based questionnaire was mailed to all CWIG members at 208 departments. It included 30 questions regarding diagnostic work-up, age for COB indication, type of COB used, daily wearing time, treatment duration, complications, and recurrence rate. Results: Members from 44 departments have responded (institutional response rate 21.2%). A total of 93% consider COB as the first-line treatment for PC. A conventional COB (CC) is used in 59%, and the dynamic compression system (FMF) in 41%. The overall compliance rate is >80%. A total of 67% of responders consider COB to be indicated in patients <10 years. The actual wearing time is significantly shorter than the physician-recommended time (p < 0.01). FMF patients experience a significantly faster response than CC patients (p < 0.01). No recurrence of PC has been noted in 34%; recurrence rates of 10–30% have been noted in 61%. Conclusions: COB is the first-line treatment for PC with a high compliance rate. During puberty, the recurrence rate is high. Treatment standardization and follow-up until the end of puberty are recommended to enhance COB effectiveness.

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