Clinical experience with orthotic repair of pectus carinatum
BACKGROUND: Pectus carinatum is a congenital chest wall deformity characterized by protrusion of the sternum and adjacent costal cartilages. Multiple treatment options are available for correction of pectus carinatum. OBJECTIVE: We report our initial experience with first-line treatment using a cust...
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| Format: | Article |
| Language: | English |
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King Faisal Specialist Hospital and Research Centre
2016-01-01
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| Series: | Annals of Saudi Medicine |
| Online Access: | https://www.annsaudimed.net/doi/full/10.5144/0256-4947.2016.70 |
| _version_ | 1818483179846107136 |
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| author | Iskander S. Al-Githmi |
| author_facet | Iskander S. Al-Githmi |
| author_sort | Iskander S. Al-Githmi |
| collection | DOAJ |
| description | BACKGROUND: Pectus carinatum is a congenital chest wall deformity characterized by protrusion of the sternum and adjacent costal cartilages. Multiple treatment options are available for correction of pectus carinatum. OBJECTIVE: We report our initial experience with first-line treatment using a custom fitted dynamic compression orthosis. DESIGN: Prospective evaluation of all patients seen between November 2013 and December 2014. SETTING: University hospital. PATIENTS AND METHODS: The treatment protocol for patients who had pressure for initial correction ≤7.5 psi included a custom-fitted and adjusted dynamic compression orthosis and frequent clinic visits. Patient satisfaction was assessed after 12 months. MAIN OUTCOME MEASURES: Patient satisfaction score. RESULTS: Eighteen patients (17 male and 1 female) (age: mean, 15.5 y; range, 10–23 y) completed treatment or continued in the study. Mean pressure for initial correction was 4.5 psi (range, 2.2–7.3 psi), bracing time was 12.8 hours/day (range, 8–24 h/d), and satisfaction score was 3 (scale: no correction, 0; complete correction, 4). There was complete correction in 7 patients (39%), remarkable improvement in 5 patients (28%), minimal improvement in 3 patients (17%), and no correction in 3 patients (17%). There were no major complications. CONCLUSION: Treatment with dynamic compression orthosis for chondrogladiolar pectus carinatum provided favorable outcomes in compliant patients. We recommend this as first-line treatment for this condition. LIMITATIONS: No objective findings. Satisfaction scores are subjective. We recommend chest CT for follow up and use of a radiological tool for comparison. |
| first_indexed | 2024-12-10T11:56:56Z |
| format | Article |
| id | doaj.art-2f87679880d54d41b334ed13f5ee4edd |
| institution | Directory Open Access Journal |
| issn | 0256-4947 0975-4466 |
| language | English |
| last_indexed | 2024-12-10T11:56:56Z |
| publishDate | 2016-01-01 |
| publisher | King Faisal Specialist Hospital and Research Centre |
| record_format | Article |
| series | Annals of Saudi Medicine |
| spelling | doaj.art-2f87679880d54d41b334ed13f5ee4edd2022-12-22T01:49:45ZengKing Faisal Specialist Hospital and Research CentreAnnals of Saudi Medicine0256-49470975-44662016-01-01361707210.5144/0256-4947.2016.70asm-1-70Clinical experience with orthotic repair of pectus carinatumIskander S. Al-Githmi0From the Division of Cardiothoracic Surgery, Department of Surgery, King Abdulaziz University Hospital, Jeddah, Saudi ArabiaBACKGROUND: Pectus carinatum is a congenital chest wall deformity characterized by protrusion of the sternum and adjacent costal cartilages. Multiple treatment options are available for correction of pectus carinatum. OBJECTIVE: We report our initial experience with first-line treatment using a custom fitted dynamic compression orthosis. DESIGN: Prospective evaluation of all patients seen between November 2013 and December 2014. SETTING: University hospital. PATIENTS AND METHODS: The treatment protocol for patients who had pressure for initial correction ≤7.5 psi included a custom-fitted and adjusted dynamic compression orthosis and frequent clinic visits. Patient satisfaction was assessed after 12 months. MAIN OUTCOME MEASURES: Patient satisfaction score. RESULTS: Eighteen patients (17 male and 1 female) (age: mean, 15.5 y; range, 10–23 y) completed treatment or continued in the study. Mean pressure for initial correction was 4.5 psi (range, 2.2–7.3 psi), bracing time was 12.8 hours/day (range, 8–24 h/d), and satisfaction score was 3 (scale: no correction, 0; complete correction, 4). There was complete correction in 7 patients (39%), remarkable improvement in 5 patients (28%), minimal improvement in 3 patients (17%), and no correction in 3 patients (17%). There were no major complications. CONCLUSION: Treatment with dynamic compression orthosis for chondrogladiolar pectus carinatum provided favorable outcomes in compliant patients. We recommend this as first-line treatment for this condition. LIMITATIONS: No objective findings. Satisfaction scores are subjective. We recommend chest CT for follow up and use of a radiological tool for comparison.https://www.annsaudimed.net/doi/full/10.5144/0256-4947.2016.70 |
| spellingShingle | Iskander S. Al-Githmi Clinical experience with orthotic repair of pectus carinatum Annals of Saudi Medicine |
| title | Clinical experience with orthotic repair of pectus carinatum |
| title_full | Clinical experience with orthotic repair of pectus carinatum |
| title_fullStr | Clinical experience with orthotic repair of pectus carinatum |
| title_full_unstemmed | Clinical experience with orthotic repair of pectus carinatum |
| title_short | Clinical experience with orthotic repair of pectus carinatum |
| title_sort | clinical experience with orthotic repair of pectus carinatum |
| url | https://www.annsaudimed.net/doi/full/10.5144/0256-4947.2016.70 |
| work_keys_str_mv | AT iskandersalgithmi clinicalexperiencewithorthoticrepairofpectuscarinatum |