Outcome of Pectus Carinatum Treatment with the FMF® Dynamic Compressor System

Abdelhamid Sherif; Sherin Elsharkawy; Dina Saad; Mahmoud Ghalwash

Abdelhamid Sherif Department of Cardiothoracic Surgery, Faculty of Medicine, Banha University, Banha, Egypt
Sherin Elsharkawy Department of Physiology, Faculty of Medicine, Banha University, Banha, Egypt and Department of Physiology, Medicine Program, Batterjee Medical college, Jeddah, Saudi Arabia
Dina Saad Department of Cardiothoracic Surgery, Faculty of Medicine, Banha University, Banha, Egypt
Mahmoud Ghalwash Department of Cardiothoracic Surgery, Faculty of Medicine, Banha University, Banha, Egypt

Keywords: Pectus Carinatum, FMF® Dynamic Compressor System, Pressure of Treatment

Abstract

Background: The use of the FMF dynamic compressor system for managing pectus carinatum (PC) has recently gained popularity. However, its efficacy and factors affecting treatment success are under investigated. The objective was to evaluate the outcome of PC treatment using an FMF dynamic compressor system.

Methods: This retrospective cohort study included 56 patients aged 13–17 years diagnosed with PC and managed using compression braces. A custom-made brace was made and applied. Patients were instructed to wear the brace to the greatest extent possible for optimal outcomes. Subsequent visits were scheduled, first every 6-8 weeks and thereafter every 3-4 months, until chest correction was achieved. The study outcomes were treatment success and complications.

Results: 46 (82.14%) had successful treatment. The pressure at initial correction was significantly lower in the successfully treated group than in the unsuccessfully treated group (6.8 ± 3 vs. 9.4 ± 3.84 psi, p=0.022). The successfully treated group had a significantly greater initial pressure of treatment than the unsuccessfully treated group (4.3 ± 1.19 vs. 2.9 ± 1.07 psi, p=0.001). The mean time to correction in the successfully treated group was 4.02 ± 1.72 months. Regarding self-assessment of the chest in the successfully treated patients, there was significant improvement after 6 (5.4 ± 1.47) and 12 months (5.5 ± 1.7) compared to the baseline assessment (2.2 ± 1.22) (p<0.001 for both), with no significant difference between the assessments after 6 and 12 months (p=0.743). Age (β: 0.132; p=0.01), the pressure of initial correction (PIC) (β: -0.214; p= 0.024), and high PIC (β: 2.092; p= 0.001) were significant risk factors for correction time.

Conclusions: A chest wall brace for treating PC with a compressive mechanism to correct this chest wall deformity might be a viable option in children and young adolescents with a high success rate.