Dekonenko Charlene, Dorman Robert M, Pierce Amy, Orrick Beth A, Juang David, Aguayo Pablo, Fraser Jason D, Oyetunji Tolulope A, Snyder Charles L, St Peter Shawn D, Holcomb George W
Department of Surgery, Children's Mercy Hospital, Kansas City, Missouri.
J Laparoendosc Adv Surg Tech A. 2019 Oct;29(10):1223-1227. doi: 10.1089/lap.2019.0171. Epub 2019 Jun 26.
Children with pectus carinatum (PC) are particularly vulnerable to psychosocial effects of poor body image, even though they may not experience physical symptoms. Nonoperative treatment with orthotic bracing is effective in PC correction. We describe our experience with dynamic compression bracing (DCB) for PC patients and their satisfaction with bracing. Prospective institutional data of patients undergoing DCB from July 2011 to June 2018 were reviewed and analyzed for those who entered the retainer mode after correction, defined by a correction pressure of <1 psi. A telephone survey was conducted regarding their bracing experience and satisfaction with the outcome on a scale of 1-10. Of 460 PC patients, 144 reached the retainer mode. Median time to retainer mode was 5.5 months. There was no statistically significant relationship between initial correction pressure or carinatum height and time to retainer mode ( = .08 and = .10, respectively). Fifty-seven percent were compliant with brace use, and median time to retainer mode in this subset was significantly shorter than noncompliant patients (3.5 months versus 10 months, < .001). Fifty-three percent responded to the survey 13 months [interquartile ratios 3, 33] after the last clinic visit. The main barrier to compliance with wearing the brace was discomfort (37%), while the main motivation for compliance was appearance (58%). All endorsed bracing as worthwhile, with 94% reporting a satisfaction rating of 8 or greater for the correction outcome. DCB is effective in achieving correction of PC in compliant patients. Regardless of time to retainer mode, patients reported high satisfaction with bracing.
鸡胸患儿特别容易受到身体形象不佳带来的心理社会影响，即使他们可能没有身体症状。使用矫形支具进行非手术治疗对鸡胸矫正有效。我们描述了我们对鸡胸患者使用动态加压支具（DCB）的经验以及他们对支具的满意度。回顾并分析了2011年7月至2018年6月接受DCB治疗的患者的前瞻性机构数据，这些患者在矫正后进入维持模式，定义为矫正压力<1磅力/平方英寸。通过电话调查了他们的支具使用经验以及对结果的满意度，评分范围为1至10分。在460例鸡胸患者中，144例达到维持模式。达到维持模式的中位时间为5.5个月。初始矫正压力或鸡胸高度与达到维持模式的时间之间无统计学显著关系（分别为P = 0.08和P = 0.10）。57%的患者依从支具使用，该亚组达到维持模式的中位时间明显短于不依从患者（3.5个月对10个月，P<0.001）。53%的患者在最后一次门诊就诊后13个月[四分位间距3，33]回复了调查。依从佩戴支具的主要障碍是不适（37%），而依从的主要动机是外观（58%）。所有患者都认可支具是值得的，94%的患者报告对矫正结果的满意度评分在8分或更高。DCB对依从的患者矫正鸡胸有效。无论达到维持模式的时间如何，患者对支具的满意度都很高。
