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Preliminary study of efficacy for dynamic compression system in the correction of pectus carinatum

Manuel Lopez¹, Olivier Tiffet², Eduardo Perez¹, Arnaud Patoir², Aurelien Villard³, François Varlet¹

¹Department of Pediatric Surgery.University Hospital of saint Etienne, Saint Etienne, France, ²Department of Adult Thoracic Surgery. University Hospital of Saint Etienne, Saint Etienne, France, ³Department of Physical Therapy. University Hospital of Saint Etienne, Saint Etienne, France

 

Abstract 

Objective: This preliminary study sought to evaluate the efficacy of a Dynamic Compression System (DCS) with a pressure measuring device of the deformity in the treatment of Pectus Carinatum (PC), as an alternative to surgery.
Methods: Patients presenting with PC, between 2011 and 2013, were enrolled in this study. The management protocol included: adjustment of the DCS, strengthening exercises, and monthly clinical follow-up. Criteria for including subjects were: patients with PC and pressure of initial correction (PIC) ≤ 9 PSI (pound square inch). The partial and final results were evaluated, using a scoring scale.
Results: A total of 65 patients were treated by DCS and included: 43 Symmetric PC, 18 Asymmetric PC, and 4 hybrid forms. The mean age was 13.5 years old. The mean PIC was 6.3 PSI.The mean utilization time was 19 hours daily. In 35 cases, group I, the treatment was completed with excellent aesthetic results. In 14 cases, group II, the normal shape of the thorax has been obtained; all patients in this group rated their results as Excellent; however, these patients are still wearing the brace as a retainer mode. 16 patients, group III, are progressing and improving under active treatment, and surgeons and patients are very satisfied with the initial results.
In the case of hybrid forms, four patients in all, two in group II and two in group III, the following treatments are performed simultaneously: cup suction for PE and DCS for PC, with very good results so far. Non patients abandoned the treatment and no complications were found.
Conclusions: This study demonstrated that DCS is effective and helpful for treatment of PC in patients where the anterior chest wall is still compliant. The control of different pressure measurements could be used as the inclusion criteria as well as a predictive factor for aesthetic results and treatment duration.