A team of researchers conducted a study to assess the long-term patient-reported outcomes of bracing therapy on adolescents diagnosed with pectus carinatum. They concluded that while bracing therapy remains an effective treatment option, 23 percent of the respondents reported the deformity returned after discontinuing bracing, and nearly one-third of patients reported negative effects from bracing therapy. Patients who reported an improvement continued bracing treatment for a longer duration.
The researchers identified 867 patients diagnosed with pectus carinatum treated at Boston Children’s Hospital between 2013 and 2023 and requested they complete a 17-question survey evaluating self-reported brace usage, cosmetic satisfaction, and quality of life outcomes.
Ninety-eight patients completed the survey; 81.6 percent were male, and 65.3 percent identified as not Hispanic or Latino. The mean age at the initial clinic visit was 12.5 years. Bracing therapy was recommended for 70 of the respondents (71.4 percent), and 51 (72.9 percent) proceeded with bracing therapy.
Among those who underwent bracing, 13.7 percent had scoliosis and 11.8 percent had connective tissue disorders, including Marfan syndrome, Ehlers-Danlos syndrome, and kyphosis.
The mean daily wear time was 8.7 hours, worn on average 6.39 days per week. Thirty-five patients (71.4 percent of 49 respondents) reported improvement in their chest wall appearance following bracing therapy. These patients braced for a significantly longer duration than those that saw no improvement in their chest wall appearance (a mean of 25.2 months versus 10.2 months).
Twelve patients (23 percent of 42 respondents) reported a return of their pectus carinatum after ending bracing therapy. Neither the number of hours worn per day nor the number of days worn per week was a statistically significant predictor of patient-reported improvement.
Complications or negative effects during bracing were reported by 16 patients(31.4 percent), including discomfort, pain, bruising/scarring, irritation of gastrostomy tube site, and poor self-esteem when bracing.
The study, “Bracing for success: Long-term patient-reported outcomes of bracing therapy for pectus carinatum,” was published in the Journal of Surgical Research.
