External Bracing (Orthotic) Technique
In children up to age 18 who have mild to moderate pectus carinatum and are highly motivated to avoid surgery, the use of a custom-fitted chest-wall brace pushing directly on the sternum produces excellent outcomes.
A child's success with this treatment approach depends on their willingness to wear the brace as required. The brace works in much the same way as braces works to correct the alignment of teeth. There are front and back compression plates that are anchored to aluminum bars. These bars are bound together by an adjustable leather strap on each side.
This device is easily hidden under clothing and must be worn over a T-shirt for at least 16 hours a day for a minimum of two years or until full height is reached. Children are taught how to tighten the straps of the brace to gradually increase the pressure applied to their chest. Parents learn how to check to see if there is the right amount of pressure. Pediatric surgeons monitor progress at office visits every three to six months.
Cincinnati Children's Hospital Medical Center is currently one of only a few centers in the country to offer this non-surgical option. Results of a recent study conducted by our team of pediatric surgeons found that most children managed with bracing showed significant correction of their deformity within the first year of treatment. This study is published in the January 2006 issue of the Journal of Pediatric Surgery.
Surgery is a possible treatment option if external bracing is contraindicated or fails.