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Patient-Reported Efficacy of the University of California, San Francisco, Custom Pectus Carinatum Orthosis JPO033-2B
Journal of Prosthetics and Orthotics: Volume 33, Issue 2
Keyword(s)
JPO033-2B
Introduction: Pectus carinatum is a bony deformity of the anterior chest wall and has a strong negative impact on patient self-esteem and quality of life. During adolescence, the deformity is often flexible and can be treated with a compressive orthosis. Compliance with orthoses yields deformity correction and self-esteem improvement (J Pediatr Surg. 2013;48:1055-1059). The purpose of this study is to evaluate the compliance to and patient satisfaction with the custom University of California, San Francisco (UCSF), Pectus Carinatum Orthosis (PCO) design.
Materials and Methods: This was a cross-sectional survey of the patients who received orthotic treatment for pectus carinatum at UCSF between August 2012 and June 2018. Potential subjects were contacted and asked to complete the Pectus Carinatum Evaluation Questionnaire (PCEQ), which was administered online via Research Electronic Data Capture. The PCEQ measures compliance as well as the physical and psychosocial impact of orthotic treatment for pectus carinatum. Results were compiled and summarized using nonparametric descriptive statistics.
Results: Of the 35 consented subjects, 12 (11 male patients and 1 female patient aged 12–17 years) completed the survey. Subjects reported an average wear time of 12.7 hours per day, 5 days a week. Seven reported no symptoms, three experienced chest pain, two reported difficulty breathing, and one had back pain. Eight reported happiness with the results of their orthotic treatment.
Conclusion: Wear times reported by the subjects were comparable with those reported in other studies looking at prefabricated pectus orthoses. However, there were lower reports of pain associated with the UCSF treatment than in other studies. Further research is necessary to determine the benefit of custom fabricated versus prefabricated PCOs. (J Prosthet Orthot. 2021;33:96–100)
Credit Information
2.0 Credits (Scientific)
Author(s)
Samantha Stauffer, MSOP; Corin Shirley, MPO, CO; Benjamin Fortson, MPO, CPO; Nicole Henry, MPO, CPO; Chrysta Irolla, MS, MSPO, CPO; Benjamin Padilla, MD
Description
Pectus carinatum (PC), also known as “pigeon chest,” is the second most common anterior chest wall deformity in the United States, with an estimated prevalence of 0.6%. It is characterized by a protrusion of the sternum most commonly attributed to costal cartilage overgrowth. It affects males more than females and is diagnosed most often in adolescence during periods of rapid growth. Family history is noted in 25% to 33% of cases, but there are no currently identified genetic indicators. The deformity rarely results in cardiopulmonary or respiratory symptoms but can have a strong negative impact on a patient's self-esteem and quality of life. Multiple studies have found that individuals with PC will avoid activities such as swimming where it is more likely that their deformity will be noticed. Body image is so impacted that Steinmann et al. found that 94.7% of patients seeking corrective surgery cited cosmesis as one justification for the procedure, and 68.4% sought surgical correction solely because of cosmesis.