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Overcorrection during treatment of pectus deformities with DCC orthoses: experience in 17 cases

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Abstract

Treatment of pectus carinatum and pectus excavatum with dynamic chest compressor (DCC) orthoses have been reported by Haje and others. The goal of this study was to demonstrate that overcorrection during orthotic treatment of children and adolescents with pectus deformities can occur and requires medical attention. Of 3,028 children and adolescents with pectus deformities, observed between 1977 and October 2005, 1,824 were prescribed treatment with DCC orthoses and, after a few months of treatment, some overcorrection was noted in 30 patients. Of the patients who received orthoses, 738 had a minimum follow-up of 1 year and 17 of these, 2 with pectus excavatum and 15 with pectus carinatum, presented overcorrection and were studied. The dynamic remodeling method (DCC orthoses + exercises) was applied. The procedures, adopted according to each patient’s needs, were: decreasing the time of orthosis wear and/or the tightening of the screws, introducing a second orthosis, and improving the prescribed exercises and/or encouraging the patient to perform them more intensively. The therapy was successful in all patients, and the result was maintained in one case of pectus excavatum followed up until adulthood. It was concluded that overcorrection during DCC orthosis wear can occur and that careful medical follow-up is necessary if this complication is to be successfully reversed.

Résumé

Le traitement du pectus carinatum et du pectus excavatum avec une orthèse dynamique (DCC) a été rapporté par Haje et coll. Le but de cette étude est de montrer que l’hypercorrection est possible. Sur 3028 enfants et adolescents atteints de déformation pectorale, observés entre 1977 et 2005, 1824 ont eu un traitement par orthèse DCC et une hypercorrection a été noté chez 30 patients. Parmi les patients traités 738 ont un suivi minimum d’un an et 17 d’entre eux (2 pectus excavatum et 15 pectus carinatum), ont une hypercorrection. Le traitement ( orthèse + exercices), adapté à chaque patient était : diminution du temps de port de l’orthèse et/ou resserrage des vis, utilisation d’une seconde orthèse et stimulation du patient pour augmenter l’intensité des exercices. Des améliorations étaient obtenues dans tous les cas et, dans un cas de pectus excavatum, maintenues jusqu’à l’âge adulte. Il est conclu que l’hypercorrection peut survenir durant le port de l’orthèse DCC et que pour la contrôler une surveillance médicale soigneuse doit être faite.

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References

  1. Beirão ME (1999) Tratamento conservador do pectus carinatum com uso de órtese. Rev Bras Ortop 34:575–578

    Google Scholar 

  2. Bianchi C et al (1968) Risultati a distanza su 20 casi di “Cifosi Sternale” tratti incruentemente. Fracastoro 61:779–792

    PubMed  CAS  Google Scholar 

  3. Egan JC, DuBois JJ, Morphy M, Samples TL, Lindell B (2000) Compressive orthotics in the treatment of asymmetric pectus carinatum: a preliminary report with an objective radiographic marker. J Pediatr Surg 35(8):1183–1186 Aug

    Article  PubMed  CAS  Google Scholar 

  4. Haje SA, Raymundo JLP (1979) Considerações sobre deformidades da parede torácica anterior e apresentação de tratamento conservador para as formas com componentes de protrusão. Rev Bras Ortop 14(4):167–178

    Google Scholar 

  5. Haje SA, Antunes EJ, Raymundo JLP, Dourado JN (1988) Pectus Carinatum: enfoque atual. Rev Bras Ortop 23(9):257–264

    Google Scholar 

  6. Haje SA, Bowen JR (1992) Preliminary results of orthotic treatment of pectus deformities in children and adolescents. J Pediatr Orthop 12(6):795–800, Nov–Dec

    PubMed  CAS  Google Scholar 

  7. Haje SA (1993/94) Pectus deformities from an orthopaedic standpoint. In: Orthopaedic Transactions of the Sixtieth Annual Meeting of the American Academy of Orthopaedic Surgeons, San Francisco, California, Feb 1993. J Bone Joint Surg Am 17(4):977–897

    Google Scholar 

  8. Haje SA (1995) Deformidades pectus: novos conceitos e abordagem ortopédica em crianças e adolescentes - 1a parte. Rev Bras Ortop 30(1,2):75–79

    Google Scholar 

  9. Haje SA (1995) Deformidades pectus: novos conceitos e abordagem ortopédica em crianças e adolescentes - 2a parte. Rev Bras Ortop 30(3):143–149

    Google Scholar 

  10. Haje SA (1995) Pectus carinatum successfully treated with bracing—a case report. Int Orthop 19(5):332–333 Letter to the Editor

    Article  PubMed  CAS  Google Scholar 

  11. Haje SA (1995) Iatrogenic pectus carinatum. A case report. Int Orthop 19(6):370–373

    Article  PubMed  CAS  Google Scholar 

  12. Haje SA (1996) Pectus carinatum iatrogênico (pós-cirurgia cardíaca pediátrica): resultados do tratamento ortótico-ortopédico-fisiátrico. Bras Med 33:93–99

    Google Scholar 

  13. Haje SA, Bowen JR, Harcke HT, Guttenberg ME, Bacon CR (1998) Disorders in the sternum growth and pectus deformities: an experimental model and clinical correlation. Acta Ortop Bras 6:67–75

    Google Scholar 

  14. Haje SA, Harcke HT, Bowen JR (1999) Growth disturbance of the sternum and pectus deformities: imaging studies and clinical correlation. Pediatr Radiol 29:334–341

    Article  PubMed  CAS  Google Scholar 

  15. Haje DP, Haje SA, Simioni MA (2002) Prevalência das deformidades pectus carinatum e pectus excavatum em escolares do Distrito Federal. Bras Med 39:10–15

    Google Scholar 

  16. Haje SA (2003) Tórax e cintura escapular. In: Hebert SK, Xavier R, Pardini AG Jr, Barros Fo TEP. Ortopedia e traumatologia: princípios e prática, 3rd edn. Artmed, Porto Alegre, pp 161–184

  17. Howard R (1958) Pigeon breast (protrusion deformity of the sternum). Med J Aust 45:664–666

    PubMed  CAS  Google Scholar 

  18. Jaubert de Beaujeu M et al (1964) Thorax en careen. Lyon Chir 60:440–443

    PubMed  CAS  Google Scholar 

  19. Lange M(1969) Torax. In: Afecciones del aparato locomotor. Trad. De Jaime Profitos Palou, Barcelona, Jims 2:543–544

  20. Mielke CH, Winter RB (1993) Pectus carinatum successfully treated with bracing. A case report. Int Orthop 17(6):350–352 Dec

    Article  PubMed  CAS  Google Scholar 

  21. Müller W (1973) Deformidades torácicas. In: Chapchal G, Waigand D (eds) Terapêutica ortopédica. Trad. De Jorge Ballester Soleda, Barcelona, Salvat 376–384

    Google Scholar 

  22. Ravitch MM (1977) Congenital deformities of the chest wall and their operative correction. Saunders, Philadelphia

    Google Scholar 

  23. Wong M, Carter DR (1988) Mechanical stress and morphogenic endochondral ossification of the sternum. J Bone Joint Surg Am 70:992–1000

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Paediatric Orthopaedics, Centro Clínico Orthopectus, Hospital Regional da Asa Norte, Secretaria de Estado da Saúde do Governo do Distrito Federal, Brasília, Brazil

    S. A. Haje

  2. Department of Paediatric Orthopaedics, Centro Clínico Orthopectus, Hospital de Base do Distrito Federal, Secretaria de Estado da Saúde do Governo do Distrito Federal, Brasília, Brazil

    D. P. Haje

  3. SHIS QL 12 conjunto 10 casa 18, 71630-305, Brasília, DF, Brazil

    S. A. Haje

Authors
  1. S. A. Haje
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  2. D. P. Haje
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Correspondence to S. A. Haje.

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Haje, S.A., Haje, D.P. Overcorrection during treatment of pectus deformities with DCC orthoses: experience in 17 cases. International Orthopaedics (SICO 30, 262–267 (2006). https://doi.org/10.1007/s00264-005-0060-0

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  • DOI: https://doi.org/10.1007/s00264-005-0060-0

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