37 EXPERIENCES OF TREATING PECTUS CARINATUM IN A MULTIDISCIPLINARY CLINIC
Kate Chauhan1,2,3, Zoe Wright1,3, David Crabbe1, Emma Sidebotham1
1Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom. 2University of Leeds, Leeds, United Kingdom. 3Steeper Group, Leeds, United Kingdom

Abstract

Aim of the Study

Pectus carinatum has traditionally been treated using surgical techniques but conservative orthotic management is increasingly popular. We reviewed our experience, 4 years after establishing a multidisciplinary clinic for managing pectus carinatum using a compressive orthotic device.

Methods

A retrospective analysis of clinic records was performed to determine outcomes. Patients were referred to the multidisciplinary clinic after review in the general outpatient clinic on two occasions by a surgeon with an interest in chest wall deformities.  Patients from out of region were assessed by two telephone consultations and photographs.  Patients had a final assessment for motivation and compliance with bracing on their first attendance at the bracing clinic prior to measurement. Patients were followed in the clinic until they and the clinic team were happy they had achieved full correction, they decided to give up with bracing or were lost to follow up.

Main Results

78 patients have been fitted with a brace.  23 have successfully completed treatment, 24 are currently in active treatment, but 31 did not complete treatment. Reasons for discontinuing treatment are detailed in the table. No patients were referred back to the clinic due to recurrence of their pectus carinatum after successful completion of treatment.

Reason for discontinuing treatment

Number of patients

Did not return after fitting

12

Brace uncomfortable

8

Brace distressing

1

Requested surgery

2

Lost to follow up

5

Happy with appearance

3

 

Conclusion

Bracing is an effective treatment for pectus carinatum provided adequate compliance is achieved.  Our patient population demonstrates a very high dropout rate despite careful assessment and education of patients and families prior to enrolment into the bracing programme. Further evaluation of these findings is required to identify factors to improve patient selection and compliance


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