Department of Physical Medicine and Rehabilitation, Marmara University School of Medicine, Istanbul, Turkey.
Department of Thoracic Surgery, Marmara University School of Medicine, Istanbul, Turkey.
Eur J Pediatr Surg. 2021 Apr;31(2):147-156. doi: 10.1055/s-0040-1701699. Epub 2020 Mar 8.
Pectus carinatum (PC) is a congenital chest wall deformity which is characterized by the protrusion of the sternum and costal cartilages. Although orthotic and exercise therapies are commonly offered by physicians for PC treatment, there is a lack of evidence on the benefits of exercises and how long the orthosis should be worn. The aim of this study is to investigate the effects and feasibility of custom-made compression orthosis and exercises in the treatment of PC.
Patients with PC aged 7 to 17 years old were randomized into three groups: compression orthosis 23 hours, compression orthosis 8 hours, and control group. All groups received exercises for 1 hour a day for 3 weeks. Additionally, compression orthosis 23 hours group wore the orthosis for 23 hours a day, while compression orthosis 8 hours group wore the orthosis for 8 hours a day. PC protrusion, pressure of correction, thorax lateral and anteroposterior parameters, external chest wall measurements, and Nuss Questionnaire were evaluated before and after the treatment. Also, adverse effects, retention, and compliance were assessed. Feasibility was evaluated by calculating the percentages of recruitment, retention, and safety.
The compression orthosis 23 hours group showed greater improvements than the other groups. After treatment, all groups showed significant changes in protrusion, pressure of correction, and external chest wall measurements. Adverse events occurred with similar frequency across groups. Retention percentages did not differ among groups.
Compression orthosis use for 23 hours can be recommended rather than its use for 8 hours because 23 hours of orthosis use has better correction and similar adverse effects.
鸡胸（pectus carinatum，PC）是一种先天性胸廓畸形，其特征为胸骨和肋软骨突出。尽管医生通常会提供矫形和运动疗法来治疗 PC，但对于运动的益处以及矫形器应佩戴多长时间，目前缺乏相关证据。本研究旨在探讨定制式压迫矫形器和运动疗法治疗 PC 的效果和可行性。
将 7 至 17 岁的 PC 患者随机分为三组：23 小时压迫矫形器组、8 小时压迫矫形器组和对照组。所有组均接受每天 1 小时的运动治疗，共 3 周。此外，23 小时压迫矫形器组每天佩戴矫形器 23 小时，而 8 小时压迫矫形器组每天佩戴矫形器 8 小时。在治疗前后评估 PC 突出度、矫正压力、胸廓侧位和前后位参数、胸廓外部测量值和 Nuss 问卷。还评估了不良事件、保留率和依从性。通过计算招募、保留和安全性的百分比来评估可行性。
23 小时压迫矫形器组的改善程度大于其他两组。治疗后，所有组的突出度、矫正压力和胸廓外部测量值均有显著变化。各组不良事件的发生频率相似。各组保留率无差异。
建议使用压迫矫形器 23 小时而非 8 小时，因为 23 小时的矫形器使用具有更好的矫正效果且不良反应相似。
