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NESS 2006 Annual Meeting
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Compressive Orthotics; A New Paradigm in The Non-Operative Correction of Pectus Carinatum in Children
Arun A Mavanur1, Donald Hight2, Alisa Edwards3, Brian Tallman3, James Fazio3
1University of Connecticut, Farmington, CT;2Connecticut Childrens Hospital/UCONN, Hartford, CT;3Hanger Orthotics, Hartford, CT

Objective: Determine the outcome of patients with pectus carinatum treated with external compressive orthotic brace.
Design: A prospective cohort study
Setting: Tertiary children’s hospital
Patients: Pediatric patients with pectus carinatum needing correction since January 2005. Twenty-four consecutive patients treated with a compressive orthotic brace.
Inteventions: Measurement of individual patient and application of a custom made compressive orthotic brace. The brace consists of semi rigid adjustable elliptical ring like device with pads anteriorly and posteriorly. The brace is custom made to allow remodeling of the chest wall as necessary for the individual patient. All patients had regular follow up to assess progress and to institute any changes in the brace as necessary. Patients are advised to leave the brace on for at least 16 hours per day.
Main Outcome Measures: At regular intervals all patients had a surface chest wall scan performed which was then analyzed using a computer software program. This allowed us to analyze the change in the deformity and also to obtain antero-posterior measurements. Photographs were also obtained to demonstrate cosmetic outcome.
Results: A total of 24 patients (22 male) with a mean age of 14 have had the brace on for a mean duration of 6 months (range 2-15).The average change in A-P dimension after correction was 7.7cms. All have had good cosmetic improvement to date. No patient has needed surgery. No Complications encountered.
Conclusions: Compressive orthotics is safe and can provide good correction with excellent cosmetic results without surgery.

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