Bracing of children with pectus carinatum: A literature review

Abstract

BACKGROUND: Conservative treatment of children with carinatum is currently an urgent and unresolved problem despite the wide range of techniques available. Conservative treatment stops the progression of deformation and reduces the degree of deformation or eliminates it. Methods of evaluating treatment results include clinical (photo–video assessment, questionnaire survey, and chest measurements) and instrumental diagnostics (radiography, computed tomography [CT], and 3D scanning); however, no method of correction and orthosis that would consider all the tasks of conservative treatment, method of evaluating conservative treatment, and uniform protocol have been established. AIM: This study aimed to analyze the literature containing information on the conservative treatment of patients with pectus carinatum. MATERIALS AND METHODS: The study presents the results of a search in PubMed, Cochrane, and eLibrary using combinations of operators and keywords. A total of 54 foreign and domestic sources were extracted, and the search was not limited retrospectively. RESULTS: Orthosis is effective and positively perceived by doctors and patients. The most modern designs in the treatment of carinatum included dynamic orthoses FMF-DCS and Braceworks (Calgary). Recent studies have reported a strong correlation between 3D scanning and CT to assess treatment outcomes. However, no single option for conservative correction of deformity allowed for achieving all treatment goals. The assessment of the effectiveness of orthosis using photos, videos, and questionnaire, and chest measurement is subjective. CONCLUSIONS: The disadvantages of prosthetics determine the need to develop a clear treatment algorithm, methodology, and objective assessment of treatment outcomes, requiring further research.