Compressive orthotics in the treatment of asymmetric pectus carinatum: A preliminary report with an objective radiographic marker

Background/Purpose: Pectus carinatum (PC) traditionally has been managed wi th surgical reconstruction. Compressive orthosis also has resulted in subje ctive improvement in this defect. The goal of the authors was to develop an alternative brace and an objective radiographic marker to monitor the effe cts of chest wall compression on sternal protrusion. Methods: Baseline chest computed tomography (CT) scans were obtained for 5 teenage boys with chondrogladiolar type of PC. The angle at the point of gr eatest sternal rotation was measured as the baseline deformity. Compressive orthosis was initiated using a custom-fitted brace. Follow-up chest CT sca ns were obtained to document change in sternal rotation. Results: One patient was lost to follow-up after 6 months with subjective i mprovement. Another opted for surgical correction after 3 months, having sh own a 16% decrease in sternal rotation preoperatively. Two patients showed subjective improvement corroborated by 33% and 44% decreases in sternal rot ation. The fifth patient, who discontinued bracing after 1 month, showed a 25% increase 6 months later. Conclusions: Preliminary results indicate a potential role for compressive orthosis in the management of pectus carinatum, The objective radiographic marker described may be used to monitor the effects of growth or treatment with compressive orthosis.