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R. B. Winter - One of the best experts on this subject based on the ideXlab platform.
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Pectus carinatum successfully treated with bracing
International Orthopaedics, 1993Co-Authors: C. H. Mielke, R. B. WinterAbstract:Nous présentons le cas d'une jeune fille de 14 ans traitée pour un thorax en carène (Pectus carinatum). Elle a été traitée initialement par un corset plâtré pendant six semaines, suivi d'un corset orthopédique pendant sept mois. Le même corset a ensuite été porté seulement la nuit pendant huit mois. Sept ans plus tard la patiente a un résultat cosmétique excellent, sans récidive. Chez un sujet bien motivé, en cours de croissance, le port d'un corset orthopédique peut être efficace dans la correction d'un thorax en carène, pour raison esthétique. We report the case of a 14 year old girl who desired treatment for a cosmetically objectionable Pectus carinatum deformity. She was initially managed with a corrective underarm body cast for six weeks followed by fulltime bracing for seven months. Subsequently, she was braced only at night for another eight months. Seven years after the onset of treatment she had an excellent result without recurrence of deformity. In a well-motivated, skeletally immature individual bracing can be an effective treatment for cosmetically displeasing Pectus carinatum.
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Pectus carinatum successfully treated with bracing : a case report
International orthopaedics, 1993Co-Authors: C. H. Mielke, R. B. WinterAbstract:We report the case of a 14 year old girl who desired treatment for a cosmetically objectionable Pectus carinatum deformity. She was initially managed with a corrective underarm body cast for six weeks followed by fulltime bracing for seven months. Subsequently, she was braced only at night for another eight months. Seven years after the onset of treatment she had an excellent result without recurrence of deformity. In a well-motivated, skeletally immature individual bracing can be an effective treatment for cosmetically displeasing Pectus carinatum.
Sungsoo Lee - One of the best experts on this subject based on the ideXlab platform.
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Minimally Invasive Repair of Pectus carinatum in Patients Unsuited to Bracing Therapy
The Korean journal of thoracic and cardiovascular surgery, 2016Co-Authors: Jee Won Suh, Seok Joo Joo, Geun Dong Lee, Seok Jin Haam, Sungsoo LeeAbstract:Background: We used an Abramson technique for minimally invasive repair of Pectus carinatum in patients who preferred surgery to brace therapy, had been unsuccessfully treated via brace therapy, or were unsuitable for brace therapy because of a rigid chest wall. Methods: Between July 2011 and May 2015, 16 patients with Pectus carinatum underwent minimally invasive surgery. Results: The mean age of the patients was 24.35±13.20 years (range, 14–57 years), and all patients were male. The percentage of excellent aesthetic results, as rated by the patients, was 37.5%, and the percentage of good results was 56.25%. The preoperative and postoperative Haller Index values were 2.01±0.19 (range, 1.60–2.31), and 2.22±0.19 (range, 1.87–2.50), respectively (p-value=0.01), and the median hospital stay was 7.09±2.91 days (range, 5–15 days). Only one patient experienced postoperative complications. Conclusion: Minimally invasive repair is effective for the treatment of Pectus carinatum, even in adult patients.
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The etiology of Pectus carinatum involves overgrowth of costal cartilage and undergrowth of ribs
Journal of pediatric surgery, 2014Co-Authors: Chul Hwan Park, Seok Jin Haam, Tae Hoon Kim, Inhwan Jeon, Sungsoo LeeAbstract:Abstract Purpose We compared the length of costal cartilage and rib between patients with symmetric Pectus carinatum and controls without anterior chest wall protrusion, using a 3-dimensional (3D) computed tomography (CT) to evaluate whether the overgrowth of costal cartilage exists in patients with Pectus carinatum. Subjects and methods Twenty-six patients with symmetric Pectus carinatum and matched twenty-six controls without chest wall protrusion were enrolled. We measured the full lengths of the 4th–6th ribs and costal cartilages using 3-D volume rendering CT images and the curved multiplanar reformatted (MPR) techniques. The lengths of ribs and costal cartilages, the summation of rib and costal cartilage lengths, and the costal index [length of cartilage/length of rib * 100 (%)] were compared between the patients group and the control group at 4th–6th levels. Results The lengths of costal cartilage in patient group were significantly longer than those of control group at 4th, 5th and 6th rib level. The lengths of ribs in patient group were significantly shorter than those of control group at 4th, 5th and 6th rib level. The summations of rib and costal cartilage lengths were not longer in patients group than in control group. The costal indices were significantly larger in patients group than in control groups at 4th, 5th and 6th rib level. Conclusion In patients with symmetric Pectus carinatum, the lengths of costal cartilage were longer but the lengths of rib were shorter than those of controls. These findings may supports that the overgrowth of costal cartilage was not the only factor responsible for Pectus carinatum.
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factors affecting patient compliance with compressive brace therapy for Pectus carinatum
T201405811.pdf, 2014Co-Authors: Du Young Kang, Junho Jung, Sangho Chung, Sungsoo Lee, Jinkyung ChoAbstract:OBJECTIVES: The aim of this study was to identify factors affecting patient compliance with brace therapy for Pectus carinatum. METHODS: Eighty-six Pectus carinatum patients who started brace therapy from August 2008 to November 2011 were included in this study. Patients were divided into two groups: patients who wore the brace for ≥6 months (compliance group) or patients who wore the brace for <6 months (non-compliance group). Factors affecting patient compliance were assessed at the last day of follow-up with a multiple-choice questionnaire. The questionnaire comprised seven items: pain at compression site, skin problems on compression area, confidence in brace treatment, shame, discomfort, initial result of bracing treatment and total number of factors affecting patient compliance. RESULTS: Eighty-six patients completed the survey, including seven (8.1%) female patients and 79 (91.9%) male patients, with a mean age of 12.0 years at the time of treatment (range, 3–20 years). The initial result of the compression period (P <0.001) and total number of factors affecting patient compliance (P <0.05) were significant predictors of patient compliance. CONCLUSIONS: An initial successful result of the compression period may increase patient compliance during treatment for Pectus carinatum. Additional efforts to decrease pain, skin problems, shame and discomfort, and to give confidence may be beneficial in increasing compliance with bracing treatment.
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Does overgrowth of costal cartilage cause Pectus carinatum? A three-dimensional computed tomography evaluation of rib length and costal cartilage length in patients with asymmetric Pectus carinatum
Interactive cardiovascular and thoracic surgery, 2013Co-Authors: Chul Hwan Park, Seok Jin Haam, Tae Hoon Kim, Sungsoo LeeAbstract:Objectives To evaluate whether the overgrowth of costal cartilage may cause Pectus carinatum using three-dimensional (3D) computed tomography (CT). Methods Twenty-two patients with asymmetric Pectus carinatum were included. The fourth, fifth and sixth ribs and costal cartilages were semi-automatically traced, and their full lengths were measured on three-dimensional CT images using curved multi-planar reformatted (MPR) techniques. The rib length and costal cartilage length, the total combined length of the rib and costal cartilage and the ratio of the cartilage and rib lengths (C/R ratio) in each patient were compared between the protruding side and the opposite side at the levels of the fourth, fifth and sixth ribs. Results The length of the costal cartilage was not different between the more protruded side and the contralateral side (55.8 ± 9.8 mm vs 55.9 ± 9.3 mm at the fourth, 70 ± 10.8 mm vs 71.6 ± 10.8 mm at the fifth and 97.8 ± 13.2 mm vs 99.8 ± 15.5 mm at the sixth; P > 0.05). There were also no significant differences between the lengths of ribs. (265.8 ± 34.9 mm vs 266.3 ± 32.9 mm at the fourth, 279.7 ± 32.7 mm vs 280.6 ± 32.4 mm at the fifth and 283.8 ± 33.9 mm vs 283.9 ± 32.3 mm at the sixth; P > 0.05). There was no statistically significant difference in either the total length of rib and costal cartilage or the C/R ratio according to side of the chest (P > 0.05). Conclusions In patients with asymmetric Pectus carinatum, the lengths of the fourth, fifth and sixth costal cartilage on the more protruded side were not different from those on the contralateral side. These findings suggest that overgrowth of costal cartilage cannot explain the asymmetric protrusion of anterior chest wall and may not be the main cause of Pectus carinatum.
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Brace Compression for Treatment of Pectus carinatum
The Korean journal of thoracic and cardiovascular surgery, 2012Co-Authors: Joonho Jung, Sangho Chung, Jin Kyoung Cho, Soojin Park, Ho Choi, Sungsoo LeeAbstract:Background: Surgery has been the classical treatment of Pectus carinatum (PC), though compressive orthotic braces have shown successful results in recent years. We propose a non-operative approach using a lightweight, patient- controlled dynamic chest-bracing device. Materials and Methods: Eighteen patients with PC were treated between July 2008 and June 2009. The treatment involved fitting of the brace, which was worn for at least 20 hours per day for 6 months. Their degree of satisfaction (1, no correction; 4, remarkable correction) was measured at 12 months after the initiation of the treatment. Results: Thirteen (72.2%) patients completed the treatment (mean time, 4.9±1.4 months). In patients who completed the treatment, the mean overall satisfaction score was 3.73±0.39. The mean satisfaction score was 4, and there was no recurrence of Pectus carinatum in patients who underwent the treatment for at least 6 months. Minimal recurrence of Pectus carinatum after removal of the compressive brace occurred in 5 (38.5%) patients who stopped wearing the compressive brace at 4 months. Conclusion: Compressive bracing results in a significant improvement in PC appearance in patients with an immature skeleton. However, patient compliance and diligent follow-up appear to be paramount for the success of this method of treatment. We currently offer this approach as a first-line treatment for PC.
C. H. Mielke - One of the best experts on this subject based on the ideXlab platform.
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Pectus carinatum successfully treated with bracing
International Orthopaedics, 1993Co-Authors: C. H. Mielke, R. B. WinterAbstract:Nous présentons le cas d'une jeune fille de 14 ans traitée pour un thorax en carène (Pectus carinatum). Elle a été traitée initialement par un corset plâtré pendant six semaines, suivi d'un corset orthopédique pendant sept mois. Le même corset a ensuite été porté seulement la nuit pendant huit mois. Sept ans plus tard la patiente a un résultat cosmétique excellent, sans récidive. Chez un sujet bien motivé, en cours de croissance, le port d'un corset orthopédique peut être efficace dans la correction d'un thorax en carène, pour raison esthétique. We report the case of a 14 year old girl who desired treatment for a cosmetically objectionable Pectus carinatum deformity. She was initially managed with a corrective underarm body cast for six weeks followed by fulltime bracing for seven months. Subsequently, she was braced only at night for another eight months. Seven years after the onset of treatment she had an excellent result without recurrence of deformity. In a well-motivated, skeletally immature individual bracing can be an effective treatment for cosmetically displeasing Pectus carinatum.
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Pectus carinatum successfully treated with bracing : a case report
International orthopaedics, 1993Co-Authors: C. H. Mielke, R. B. WinterAbstract:We report the case of a 14 year old girl who desired treatment for a cosmetically objectionable Pectus carinatum deformity. She was initially managed with a corrective underarm body cast for six weeks followed by fulltime bracing for seven months. Subsequently, she was braced only at night for another eight months. Seven years after the onset of treatment she had an excellent result without recurrence of deformity. In a well-motivated, skeletally immature individual bracing can be an effective treatment for cosmetically displeasing Pectus carinatum.
In-hag Song - One of the best experts on this subject based on the ideXlab platform.
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Repair of Pectus carinatum, carinatum/excavatum complex patients with doubly double bar technique
General Thoracic and Cardiovascular Surgery, 2020Co-Authors: In-hag SongAbstract:Surgical correction is needed for patients with Pectus carinatum who do not adapt to bracing therapy. We performed the doubly double bar technique for ten patients who did not adapt to bracing therapy for patients with Pectus carinatum and/or carinatum/excavatum complex type. A complete correction was achieved for all patients, and there were no complications. Our initial experience suggests that the doubly double bar technique can be performed effectively for Pectus carinatum and/or carinatum/excavatum complex type patients.
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Minimal invasive extrathoracic presternal compression using a metal bar for correction of Pectus carinatum
Pediatric Surgery International, 2014Co-Authors: Seock Yeol Lee, In-hag Song, Seung Jin LeeAbstract:Background This report presents early results of surgical experience of minimal invasive extrathoracic presternal compression using a metal bar for correction of the Pectus carinatum. Methods From February 2008 to February 2012, 15 patients with combined Pectus carinatum and Pectus excavatum underwent minimal invasive extrathoracic presternal compression using a metal bar for correction of Pectus carinatum and Nuss operation for Pectus excavatum. After 2 years, bar removal was done in all patients. In this paper, we focused on Pectus carinatum repair. The effects and complications of the minimally invasive extrathoracic presternal compression using a metal bar for correction of Pectus carinatum were reviewed. Results The median age was 15.7 years. The mean operation time for Pectus carinatum with Pectus excavatum was 122 min. The median length of hospitalization was 6 days. The Haller Pectus index of Pectus carinatum was 2.93 ± 0.36 pre-operatively and this was increased to 3.33 ± 0.61 post-operatively. There were no special complications. The degree of satisfaction of Pectus carinatum correction was 3.75 ± 0.46 (range 1–4). Conclusion Our results were favorable in spite of the small number of cases and short follow-up, and our modified technique of Pectus carinatum was easy and simple. However, long-term follow-up is needed to accurately evaluate the effects of this surgery in many cases.
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Minimal invasive extrathoracic presternal compression using a metal bar for correction of Pectus carinatum.
Pediatric surgery international, 2013Co-Authors: Seock Yeol Lee, In-hag Song, Seung Jin LeeAbstract:Background This report presents early results of surgical experience of minimal invasive extrathoracic presternal compression using a metal bar for correction of the Pectus carinatum.
Mehmet Bilgin - One of the best experts on this subject based on the ideXlab platform.
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Minimally invasive repair of Pectus carinatum: a retrospective analysis based on a single surgeon’s 10 years of experience
General Thoracic and Cardiovascular Surgery, 2018Co-Authors: Muharrem Özkaya, Mehmet BilginAbstract:Objectives Over the past decade, minimal invasive surgery for correction of Pectus carinatum has gained worldwide acceptance. This study reviews our clinical experience with minimally invasive repair of Pectus carinatum (MIRPC) since 2008. Methods Between 2008 and 2018, 101 patients (77 male, 24 female) underwent correction of Pectus carinatum with the MIRPC technique. The mean age of the patients was 14.7 ± 4.8 (3–38) years. Over an 8 years’ experience we slightly modified the original Abramson technique. All patients presented with cosmetic complaints and all had a flexible chest wall on “compression test”. Early follow-up was on postoperative day 15 and 30. Results The mean operative time was 42.1 ± 16.9 min. The mean hospital stay was 4.2 ± 0.9 days. Postoperative complications included pneumothorax ( n = 2, 1.9%), wound infection ( n = 2, 1.9%), skin perforation ( n = 2, 1.9%), intolerable pain ( n = 1, 0.9%), skin hyperpigmentation ( n = 1, 0.9%), and overcorrection ( n = 1, 0.9%). Initial postoperative results were excellent in all patients. The bars were removed at a median of 24.8 ± 4.5 months in 44 of 101 patients. 43 of 44 (97.7%) patients whose bar were removed reported excellent results. Conclusions MIRPC is a feasible procedure with low morbidity and excellent cosmetic results in the treatment of Pectus carinatum deformities in selected patients.
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Minimally invasive repair of Pectus carinatum: a retrospective analysis based on a single surgeon's 10 years of experience.
General thoracic and cardiovascular surgery, 2018Co-Authors: Muharrem Özkaya, Mehmet BilginAbstract:OBJECTIVES Over the past decade, minimal invasive surgery for correction of Pectus carinatum has gained worldwide acceptance. This study reviews our clinical experience with minimally invasive repair of Pectus carinatum (MIRPC) since 2008. METHODS Between 2008 and 2018, 101 patients (77 male, 24 female) underwent correction of Pectus carinatum with the MIRPC technique. The mean age of the patients was 14.7 ± 4.8 (3-38) years. Over an 8 years' experience we slightly modified the original Abramson technique. All patients presented with cosmetic complaints and all had a flexible chest wall on "compression test". Early follow-up was on postoperative day 15 and 30. RESULTS The mean operative time was 42.1 ± 16.9 min. The mean hospital stay was 4.2 ± 0.9 days. Postoperative complications included pneumothorax (n = 2, 1.9%), wound infection (n = 2, 1.9%), skin perforation (n = 2, 1.9%), intolerable pain (n = 1, 0.9%), skin hyperpigmentation (n = 1, 0.9%), and overcorrection (n = 1, 0.9%). Initial postoperative results were excellent in all patients. The bars were removed at a median of 24.8 ± 4.5 months in 44 of 101 patients. 43 of 44 (97.7%) patients whose bar were removed reported excellent results. CONCLUSIONS MIRPC is a feasible procedure with low morbidity and excellent cosmetic results in the treatment of Pectus carinatum deformities in selected patients.
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Minimally invasive repair of Pectus carinatum by modification of the Abramson technique.
Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques, 2018Co-Authors: Muharrem Özkaya, Mehmet BilginAbstract:Introduction The minimally invasive Pectus carinatum surgery described by Abramson has been performed in many centers. We modified the "sub-muscular tunnel creation" part of the original Abramson technique. Aim To compare the operative time between the original Abramson technique and a lightly modified approach. Material and methods A retrospective review of 84 patients who underwent minimally invasive repair of Pectus carinatum deformity between July 2008 and November 2017 was performed. We applied two different techniques, the original Abramson technique and the modified technique. Sixty-eight patients - 49 (72%) males and 19 (28%) females - underwent minimally invasive repair of a Pectus carinatum deformity as described by Abramson (Abramson group). Sixteen patients - 13 (81%) males and 3 (19%) females - were operated on by our modified Abramson technique at our institution (Modified group). Results Eighty-four patients were included in this study: 68 patients from the Abramson group and 16 patients from the Modified group. There was no significant difference between the groups with respect to preoperative demographic features, including median age and sex. Median operative time was significantly shorter in the Modified group than the Abramson group (43 min, range: 32-54 min) in the Modified group vs. 30 min (range: 20-35 min) in the Abramson group (p < 0.001). Conclusions This article describes a modification of a surgical technique that is safely and easily used in minimally invasive correction of Pectus carinatum deformities, with minimal complications, high satisfaction rates and shorter operative time.