Document Detail

Staged management of pectus carinatum.
MedLine Citation:
PMID:  23414858     Owner:  NLM     Status:  In-Data-Review    
AIM: The aim was to report the treatment of pectus carinatum with a novel Argentine brace and operation.
METHODS: The bracing and clinical data of 137 consenting pectus carinatum patients treated between October 2008 and December 2011 were reviewed for outcome. Institutional approval was obtained. Data are reported as median (range).
RESULTS: Median age 122 bracing patients was 14 (10-28)years with 67 (55%) progressing under active treatment. Five patients (4%) were lost to follow-up, and thirteen (11%) failed treatment. Thirty-seven patients (30%) exhibited flattening of the sternum after 6 (1-24)months without surgery. After flattening, patients then wore the brace for progressively fewer hours each day as a "retainer" for 5 (3-19)months. Five patients (4%) experienced recurrence 5 (3-7)months after brace treatment was discontinued. Complications were limited to transient skin breakdown in nine patients. Three of the 13 Argentine brace failures and 15 other pectus carinatum patients were treated surgically. Thirteen underwent Abramson's minimally invasive operation and five an open repair, all with good initial correction. For Abramson repairs, seven patients have had bars removed, with results rated as excellent (n=4), good (n=2), and failure (n=1, converted to open with excellent result later). In three patients with stiff chests, costal cartilage was resected thoracoscopically during the Abramson repair with measurably improving compliance.
CONCLUSION: Staged treatment of pectus carinatum allows most teenagers to be managed non-operatively. For patients who fail bracing or are not amenable to bracing, minimally invasive surgical treatment for pectus carinatum is a viable option.
Amy S Cohee; James R Lin; Frazier W Frantz; Robert E Kelly
Related Documents :
12632198 - Molding the ears after anterior scoring and concha repositioning: a combined approach f...
23413848 - Predicting successful outcomes of wrist and finger ganglia.
23794548 - Prognostication of recovery time after acute peripheral facial palsy: a prospective coh...
22682788 - Walking ability of children with a hexapod external ring fixator (tsf(®)) and foot plat...
16273378 - Modified steindler procedure for the treatment of brachial plexus injuries.
21549918 - Longevity and outcomes of axillary valve transplantation for severe lower extremity chr...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  48     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-02-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  315-20     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 Elsevier Inc. All rights reserved.
Children's Hospital of The King's Daughters, Norfolk, VA 23507, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Congenital emphysema in children: Segmental lung resection as an alternative to lobectomy.
Next Document:  Thoracoscopic repair of neonatal congenital diaphragmatic hernia (CDH): Outcomes after a systematic ...