Dynamic Compression Therapy for Pectus Carinatum in Children and Adolescents: Factors for Success.

• What is currently known about this topic? • What new information is contained in this article? • Pectus carinatum is increasingly treated with dynamic compression therapy. Factors for success for are relatively unknown. • The pressure of initial correction and height of deformity are predictors for the total treatment time and the time to correction. Chest scores improved in the first months after start of treatment. Scores remained high. Pectus carinatum (PC) is a congenital chest wall deformity. In childhood, it is increasingly treated with dynamic compression therapy. Factors for success for dynamic brace therapy are relatively unknown. Between 2013 and 2020, 740 patients treated with the Dynamic Compression System (DCS), were studied. This included the effect of age, gender, pectus height, symmetry and pectus rigidity on treatment time and symptoms with linear multiple regression analyses. Carinatum height and high pressure of initial correction at the start of treatment were associated with a prolonged duration of treatment. For each cm increase in carinatum height, the total treatment duration increased with 1.9 months (p -value= 0.002, 95% CI: 0.70–3.13). An initial correction pressure of ≥7.6 pounds per square inch (psi), increased the treatment duration with 3.5 months (p -value 0.006, 95% CI: 1.04–6.01) compared to an initial correction pressure of ≤5.0 psi. A high initial pressure of correction of ≥7.6 psi increased the odds of having somatic symptoms with 1.19 (p -value= 0.012, 95% CI: 1.04–1.45) and psychosocial symptoms with 1.13 (p -value= 0.04, 95% CI: 1.01–1.27) compared to a low initial pressure of correction of ≤5.0 psi. An initial pressure of correction of 5.1–7.5 psi increased the odds of having somatic symptoms with 1.14 (p -value 0.046, 95% CI: 1.00–1.29) compared to an initial pressure of correction of ≤5.0 psi. Patients with asymmetric chests were more likely to abandon therapy High carinatum height and high initial pressure of correction are associated with prolonged bracing treatment and a higher failure rate. III [ABSTRACT FROM AUTHOR]