Initial reduction of flexible pectus carinatum with outpatient manipulation as an adjunct to external compressive bracing: technique and early outcomes at 12 weeks
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Read the article on jpedsurg.org ↗Article · Nov 2019 · 1 min read
In brief
In brief
This study of 177 patients demonstrates that initial outpatient soft-tissue manipulation before external bracing for flexible pectus carinatum maintains Haller Index reduction without progressive tightening, achieving high patient compliance and satisfaction with minimal complications over 12 weeks.
Written by the GCMD Library team from the article.
Introduction
Our aim was to assess whether initial reduction with outpatient soft-tissue manipulation of flexible pectus carinatum deformity prior to external compressive bracing was associated with improved compliance and patient satisfaction compared to reported outcomes of external brace with progressive tightening.
Materials and methods
From our observational cohort of 227 patients, 177 were felt appropriate to undergo initial reduction and soft tissue manipulation prior to immediate custom fitting of an external compressive brace. These patients then followed a prescriptive schedule of 12 weeks of continuous external bracing with subsequent follow-up in clinic.
Results
The reduction in Haller Index was maintained throughout the period of external bracing without the need for progressive tightening of the external brace. The treatment was associated with high levels of patient satisfaction and high patient concordance compared to other protocols. There were no major complications and minor complications included only skin irritation.
Conclusions
Out-patient initial reduction with manipulation prior to external compressive bracing is a novel technique which resulted in excellent concordance and high rates of patient satisfaction and should be considered as an adjunct to standard external bracing techniques.
Type of Study
Treatment Study.
Level of Evidence
Level II.