Pectus carinatum is a chest wall deformity resulting in abnormal protrusion of the sternum or costal cartilage. This deformity is typically treated when a child is between 10 and 15 years old. The first-line treatment for flexible chondrogladiolar pectus carinatum is a compression orthosis that provides anterior-posterior compression over the protruding area. This external force is maintained through the treat- ment period to allow remodeling of bone and connective tissue following Wolff's Law.

Orthosis dosage is important in the treatment of pectus carinatum. Dosage in the context of orthoses refers to both the wear quantity and quality. Wear quantity is the amount of time the patient wears the orthosis each day and the duration of the treatment period. The wear quality refers to whether the orthosis is donned in the appropriate position on the body and is appropriately tight. Compliance monitoring has shown utility in measuring wear quantity; however, little has been done to monitor wear quality.

There is one orthosis design on the market that controls wear quality. The dynamic compression system (DCS or FMF orthosis) introduced pressure management to the treatment of pectus carinatum.3 Two key pressure values that were introduced were the pressure of initial correction (PIC) and the pressure of treatment (POT). The PIC is used as a metric to determine orthosis candidacy. The POT is an objective measurement of wear quality. This value represents the pressure the orthosis applies to the deformity when the orthosis is latched closed. Unlike most other orthoses, the tightness is preset by the treating orthotist rather than the patient.

While this technique introduced the concept of pressure measurement, it also necessitated specialized pressure sensors, electronics, and frequent follow-up appointments with the orthotist for retightening to the desired POT. The purpose of this study was to present a novel closure style that utilizes a slip torque tool to apply a prescribed POT without the need for electronics or frequent follow-ups.