Sesia Sergio B, Holland-Cunz Stefan, Häcker Frank-Martin
Department of Pediatric Surgery, University Children's Hospital Basel, Basel, Switzerland.
Eur J Pediatr Surg. 2016 Dec;26(6):481-486. doi: 10.1055/s-0035-1570758. Epub 2016 Jan 8.
Several nonoperative treatments are currently available for the correction of pectus carinatum (PC). The objective of this study is to report our single center experience with the dynamic compression system (DCS). The DCS is a rigid aluminum brace. PC is reshaped into a normal appearance through anterior-posterior pressure and lateral expansion of the chest. Patients with chondrogladiolar PC were considered suitable for the nonoperative treatment with DCS. In this study, 53 of 68 children (78%) with chondrogladiolar PC were assessed retrospectively: 2 children were corrected by surgery, 12/53 (23%) treated by a conventional orthesis, 11/53 (21%) remained without therapy because of minor PC, and 36/53 (68%) were treated using the DCS. Of these 36 patients, 17 (47%) are already cured with a good (7/17) to excellent (10/17) cosmetic result after a median treatment period of 9 months (range, 2.5-16 months). The mean daily time of wearing of the device for those 17 patients was 9 hours (range, 5-18). None abandoned the treatment and there were almost no complications. Lateral expansion of the chest and the possibility to measure the applied pressure seemed to be the key to DCSs success. We propose the DCS as first choice in the treatment of chondrogladiolar PC in children.
目前有几种非手术治疗方法可用于矫正鸡胸（PC）。本研究的目的是报告我们单中心使用动态压缩系统（DCS）的经验。DCS是一种刚性铝制支架。通过前后压力和胸部横向扩张，将鸡胸重塑为正常外观。剑突软骨型鸡胸患者被认为适合采用DCS进行非手术治疗。在本研究中，对68例剑突软骨型鸡胸患儿中的53例（78%）进行了回顾性评估：2例患儿接受了手术矫正，12/53（23%）采用传统矫形器治疗，11/53（21%）因鸡胸较轻未接受治疗，36/53（68%）采用DCS治疗。在这36例患者中，17例（47%）在中位治疗期9个月（范围2.5 - 16个月）后已治愈，美容效果良好（7/17）至极佳（10/17）。这17例患者佩戴该装置的平均每日时长为9小时（范围5 - 18小时）。无一例放弃治疗，几乎没有并发症。胸部横向扩张以及测量施加压力的可能性似乎是DCS成功的关键。我们建议将DCS作为儿童剑突软骨型鸡胸治疗的首选方法。
