Haje Davi de Podestá, Haje Sydney Abrão, Volpon José Batista, da Silva Ana Carolina Oliveira, Lima Leonardo Ferreira Braz, Huang Wilson
Centro Clínico Orthopectus, Brasília, DF, Brazil.
Hospital de Base do Distrito Federal, Department of Orthopedic Surgery, Brasília, DF, Brazil.
Acta Ortop Bras. 2021 Jul-Aug;29(4):197-202. doi: 10.1590/1413-785220212904243419.
This study aims the treatment results of broad pectus excavatum after a long-term follow-up and skeletal maturity.
Eighty-four children and adolescents with broad-type pectus excavatum were selected for evaluation after treatment with a dynamic orthosis that applies compression to the lower rib projections and prescription of exercises. The broad pectus excavatum was defined as a deformity that the depressed area was greater and covered the area above and below the nipple line. All patients were evaluated for more than 1 year after the end of treatment and skeletal maturity. Post-treatment results were categorized as mild, moderate and severe. Statistic correlations between results and deformity flexibility, deformity severity, and adherence to treatment were assessed.
The mean age at the beginning of treatment was 13.3 years, and the follow-up duration was 25.7 months after suspension of orthosis use. Forty-eight percent of patients showed good results. With regular use of orthoses and performance of exercises, this rate increased to 70% (p < 0,001). Mild cases showed more success than severe cases (p = 0,007). Initial flexibility didn't influence the results (p = 0,63).
Treatment of broad pectus excavatum with orthoses and exercises led to good definitive results in most resilient patients, especially in those with mild deformities.
本研究旨在探讨广泛型漏斗胸长期随访及骨骼成熟后的治疗效果。
选取84例接受动态矫形器治疗（对下肋骨突出部位施加压力）及运动处方治疗的广泛型漏斗胸儿童和青少年进行评估。广泛型漏斗胸定义为凹陷区域较大且覆盖乳头线上下区域的畸形。所有患者在治疗结束及骨骼成熟后接受了超过1年的评估。治疗后结果分为轻度、中度和重度。评估结果与畸形柔韧性、畸形严重程度及治疗依从性之间的统计学相关性。
治疗开始时的平均年龄为13.3岁，停止使用矫形器后的随访时间为25.7个月。48%的患者显示出良好效果。通过定期使用矫形器和进行运动，这一比例增至70%（p<0.001）。轻度病例比重度病例成功率更高（p = 0.007）。初始柔韧性不影响结果（p = 0.63）。
使用矫形器和运动治疗广泛型漏斗胸，在大多数有弹性的患者中，尤其是轻度畸形患者中，取得了良好的最终效果。
