Journal of pediatric surgery · 2026
Non-operative treatment of pectus carinatum: Fifteen years of outcomes and predictors from a national paediatric service.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
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Dargie Donna, Johnstone Ashley, Davis Carl
Аннотация
BACKGROUND: Non-surgical bracing is the primary treatment for pectus carinatum, yet large cohorts with objectively measured adherence are limited. This study evaluates 15 years of bracing outcomes and identifies factors associated with successful correction.
METHODS: This retrospective observational cohort study included patients <20 years with chondrogladiolar pectus carinatum treated with orthotic bracing between 2010 and 2025 within the Scottish National Chest Wall Service. Chest wall flexibility was assessed subjectively prior to 2019 and objectively thereafter using a calibrated force gauge. Wear-time adherence was quantified using thermosensitive data loggers embedded within the brace. Outcomes were categorised as resolved, resolved to satisfaction, partial improvement, no improvement, lost to follow-up, or surgical referral. Associations were analysed using chi-square testing (p < 0.05).
RESULTS: A total of 612 patients met inclusion criteria. Full resolution occurred in 213 patients (34.8%), with a further 73 (11.9%) achieving resolution to patient satisfaction. Chest wall flexibility was associated with outcome (subjective p < 0.001; objective p = 0.013). Wear-time adherence demonstrated the strongest association with successful correction (p < 0.001). Patient motivation was also significantly associated with outcome (p < 0.001). Age showed no statistically significant association with outcome (p = 0.10), although a trend towards improved outcomes in younger patients was observed. Laterality was not associated with outcome (p = 0.20).
CONCLUSION: In this large cohort with objectively measured adherence, wear-time was the strongest predictor of successful correction, alongside chest wall flexibility and patient motivation. These findings support the importance of adherence monitoring and patient engagement in bracing programmes. Further work is required to determine optimal wear-time thresholds and to evaluate long-term outcomes following treatment.
LEVEL OF EVIDENCE: Retrospective study/Level of evidence III.
METHODS: This retrospective observational cohort study included patients <20 years with chondrogladiolar pectus carinatum treated with orthotic bracing between 2010 and 2025 within the Scottish National Chest Wall Service. Chest wall flexibility was assessed subjectively prior to 2019 and objectively thereafter using a calibrated force gauge. Wear-time adherence was quantified using thermosensitive data loggers embedded within the brace. Outcomes were categorised as resolved, resolved to satisfaction, partial improvement, no improvement, lost to follow-up, or surgical referral. Associations were analysed using chi-square testing (p < 0.05).
RESULTS: A total of 612 patients met inclusion criteria. Full resolution occurred in 213 patients (34.8%), with a further 73 (11.9%) achieving resolution to patient satisfaction. Chest wall flexibility was associated with outcome (subjective p < 0.001; objective p = 0.013). Wear-time adherence demonstrated the strongest association with successful correction (p < 0.001). Patient motivation was also significantly associated with outcome (p < 0.001). Age showed no statistically significant association with outcome (p = 0.10), although a trend towards improved outcomes in younger patients was observed. Laterality was not associated with outcome (p = 0.20).
CONCLUSION: In this large cohort with objectively measured adherence, wear-time was the strongest predictor of successful correction, alongside chest wall flexibility and patient motivation. These findings support the importance of adherence monitoring and patient engagement in bracing programmes. Further work is required to determine optimal wear-time thresholds and to evaluate long-term outcomes following treatment.
LEVEL OF EVIDENCE: Retrospective study/Level of evidence III.