title: Effect of the compressive brace in pectus carinatum.
abstract: BACKGROUND
  Patients with pectus carinatum complain of cosmetic problems because they stand out in spite of wearing clothes. Surgical treatment of pectus carinatum is resection of the deformed cartilage but a wide operative scar, postoperative pain and complications related with the operation can occur. Therefore we have performed compressive brace therapy as a non-operative treatment of pectus carinatum, and observed the effects and the efficiency of this treatment.
  
  
  METHODS
  From January 2001 to December 2007, 119 patients with pectus carinatum were treated with a compressive brace that they wore for 24h each day. Their degree of satisfaction was measured after 6 months wearing. This was evaluated with a score of 1-4. A score of 1 was assigned when the status was worse, 2 when it was same, 3 when partially improved, and 4 when a remarkable improvement was observed. Satisfaction was assessed subjectively by a parent if the patient was a child, and patients older than middle school age assessed the score themselves.
  
  
  RESULTS
  The mean overall satisfaction score was 3.95+/-0.4. Recurrence of pectus carinatum after removal of the compressive brace occurred in 6 (5.0%) of the total 119 patients. Four of these six patients stopped wearing the compressive brace against our advice. These six patients were re-corrected by re-wearing the compressive brace within 3 months after they originally removed it. Complications were discomfort at initial wearing of the brace, which occurred in all patients, skin rash due to compression for 84 patients (70.6%) and skin discoloration due to excessive compression for 18 patients (15.1%). The skin rash and discoloration disappeared within a few months after removal of the brace.
  
  
  CONCLUSIONS
  This study demonstrated that non-surgical treatment using a compressive brace in patients with pectus carinatum was effective, especially in children and teenagers. Non-surgical treatment using a compressive brace in patients with pectus carinatum would be helpful for those who dislike surgery because of their fear about general anesthesia and operative complications. But, long-term follow-up is necessary to evaluate the effectiveness of this compressive brace and the recurrence of the condition after its removal.
authors.affiliation: Department of Thoracic & Cardiovascular Surgery, Soonchunhyang University Cheonan Hospital, Cheonan-City, South Korea. csdoctor@korea.com
authors.forename: Seock Yeol
authors.initials: SY
authors.lastname: Lee
authors.forename: Seung Jin
authors.initials: SJ
authors.lastname: Lee
authors.forename: Cheol Woo
authors.initials: CW
authors.lastname: Jeon
authors.forename: Cheol Sae
authors.initials: CS
authors.lastname: Lee
authors.forename: Kihl Rho
authors.initials: KR
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001848:Bone Diseases, Developmental / Q000628:therapy*; D001915:Braces / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D012008:Recurrence; D012272:Ribs / Q000002:abnormalities*; D017678:Sex Distribution; D013249:Sternum / Q000002:abnormalities*; D016896:Treatment Outcome