Dynamic Compression System versus Self-Adjustable Bracing for Pectus Carinatum: Clinical Outcomes and Cost Comparison.

IF 1.8 3区医学 Q2 PEDIATRICS

European Journal of Pediatric Surgery Pub Date : 2026-10-01 Epub Date: 2026-06-16 DOI:10.1055/a-2887-9645

Sherif Emil, Yseult Gibert, Daphne Lew, Jean-Martin Laberge, Etienne St-Louis, Hussein Wissanji, Sophie Cayer, Piotr Duma, Jade Goyette, Marianne Toledo

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引用次数: 0

Abstract

Background: Bracing is the preferred treatment for pectus carinatum. However, few studies have compared outcomes of different bracing methods. We tested the hypothesis that the type of brace has no effect on outcomes.

Methods: A retrospective study of children who underwent bracing during a 10-year period (2011-2021) at a multidisciplinary chest wall anomaly center was conducted. The characteristics and outcomes of patients treated with a pressure-guided orthotist-adjusted brace (FMF Dynamic Compression System [DCS]) were compared with those treated with a simpler, less costly, self-adjustable brace (Trulife). Pressure of correction (POC) was used to assess severity. A standardized follow-up protocol was used. Patients who were still in active bracing or had inadequate follow-up were excluded.

Results: During the study period, 373 patients started bracing, with 241 (93.7% males) having sufficient data to assess outcomes (170 DCS, 71 Trulife). Bracing succeeded in 217 patients (90%). Of 24 patients who failed, the majority (17) were due to non-compliance. There were no significant differences in POC (DCS 5.27 ± 1.59 vs. Trulife 4.99 ± 1.62 psi, p = 0.219) or any other characteristics between the groups. Bracing success (DCS 89% vs. Trulife 93%, p = 0.329) and active bracing duration (5.41 ± 3.52 vs. 5.37 ± 4.28 months, p = 0.944) were similar between the two groups. Loss to follow-up was significantly higher in the Trulife group (40.7% vs. 23.7%). Use of the Trulife brace resulted in a cost savings of CAD 406,000.00.

Conclusion: With the limitations of a retrospective study, a self-adjustable brace resulted in a similar success rate and bracing duration, when compared with a pressure-guided orthotist-adjusted brace, and was associated with substantial cost savings.

Level of evidence: IV.

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动态压缩系统与自调节支架治疗胸突：临床结果和成本比较。

背景：支具是治疗胸突的首选方法。然而，很少有研究比较不同支具方法的效果。我们检验了支架类型对结果没有影响的假设。方法：对10年间（2011-2021年）在多学科胸壁异常中心接受支具治疗的儿童进行回顾性研究。使用压力引导矫形器调节支架（FMF动态压缩系统[DCS]）治疗的患者的特征和结果与使用更简单、更便宜的自调节支架（Trulife）治疗的患者进行比较。矫正压力（POC）用于评估严重程度。采用标准化的随访方案。仍在使用主动支具或随访不充分的患者被排除在外。结果：在研究期间，373例患者开始使用支具，其中241例（93.7%为男性）有足够的数据来评估结果（170例DCS， 71例Trulife）。支具成功217例（90%）。在24例失败的患者中，大多数（17例）是由于不遵守规定。两组间POC （DCS 5.27±1.59 vs Trulife 4.99±1.62 psi, p = 0.219）及其他指标均无显著差异。两组间支具成功率（DCS 89% vs Trulife 93%, p = 0.329）和有效支具持续时间（5.41±3.52 vs 5.37±4.28个月，p = 0.944）相似。Trulife组的随访失踪率明显更高（40.7%对23.7%）。使用Trulife支架节省了406,000加元的成本。结论：由于回顾性研究的局限性，与压力引导矫形器调节支具相比，自调节支具具有相似的成功率和支具持续时间，并且可以节省大量成本。证据等级：四级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Pediatric Surgery 医学-外科

CiteScore

3.90

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： This broad-based international journal updates you on vital developments in pediatric surgery through original articles, abstracts of the literature, and meeting announcements. You will find state-of-the-art information on: abdominal and thoracic surgery neurosurgery urology gynecology oncology orthopaedics traumatology anesthesiology child pathology embryology morphology Written by surgeons, physicians, anesthesiologists, radiologists, and others involved in the surgical care of neonates, infants, and children, the EJPS is an indispensable resource for all specialists.