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Background <p>Bracing therapy is a first-line non-surgical treatment for pectus carinatum , but standardized protocols, measurement of initial corrective pressure, particularly regarding wearing intensity, are lacking. This study compares the efficacy, compliance, and patient satisfaction between high-intensity and low-intensity bracing regimens in young children with pectus carinatum, utilizing three-dimensional surface scanning for objective assessment, and propose a standard measurement of initial corrective pressure.</p> Methods <p>From January 2021 to January 2025, 208 children under six years of age with pectus carinatum were enrolled and categorized into two groups based on daily brace-wearing time: a high-intensity group (&gt;16 hours/day, n=98) and a low-intensity group (8–12 hours/day, n=110). All patients received orthotic braces. Treatment progress was monitored bimonthly using 3D scanning to measure the External Haller Index. Outcomes included correction success, treatment duration, complication rates, adherence, and patient/parent satisfaction assessed via the Pectus Carinatum Evaluation Questionnaire (PCEQ).</p> Results <p>Final success rates were comparable between the low-intensity and high-intensity groups (86.3% vs. 89.8%, p&gt;0.05), with no significant difference in median correction time (7.5 ± 0.8 months vs. 7.3± 0.9 months, p=0.321). The high-intensity group showed significantly greater EHI improvement at the 2-month follow-up (1.24 ± 0.11 vs.1.18 ± 0.13, p&lt;0.05), but this difference disappeared by 4 months(1.27± 0.08 vs.1.25 ± 0.09, p=0.093). The low-intensity group demonstrated significantly better treatment compliance (95.6% vs. 89.1%, p&lt;0.05) and higher post-treatment satisfaction scores (4.5±0.3 vs. 4.2±0.4, p&lt;0.05). Complication rates were low overall (7.2%) and predominantly mild, with slightly fewer complications in the low-intensity group. One case (0.5%) of recurrence was successfully managed with brief resumed bracing.</p> Conclusion <p>A low-intensity bracing regimen achieves long-term correction efficacy comparable to a high-intensity regimen without prolonging treatment duration, while significantly improving patient compliance and satisfaction. The use of 3D scanning to standardize initial corrective pressure provides an objective benchmark for pressure adjustment. These findings support a paradigm shift towards patient-centered, low-intensity bracing strategies for pediatric PC, prioritizing tolerability and adherence to optimize overall outcomes.</p>

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A single-center experience with orthotic bracing for children with pectus carinatum

  • 期刊论文

  • 发表日期：

    2026年4月15日

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  • Song-Ming Hong,
  • Jun-Jie Hong,
  • Bo-Xiao Shi,
  • Hao-Han Shen,
  • Jing-Wen Cai,
  • Jin-Xi Huang,
  • Xiao-meng Hu

摘要

Background

Bracing therapy is a first-line non-surgical treatment for pectus carinatum , but standardized protocols, measurement of initial corrective pressure, particularly regarding wearing intensity, are lacking. This study compares the efficacy, compliance, and patient satisfaction between high-intensity and low-intensity bracing regimens in young children with pectus carinatum, utilizing three-dimensional surface scanning for objective assessment, and propose a standard measurement of initial corrective pressure.

Methods

From January 2021 to January 2025, 208 children under six years of age with pectus carinatum were enrolled and categorized into two groups based on daily brace-wearing time: a high-intensity group (>16 hours/day, n=98) and a low-intensity group (8–12 hours/day, n=110). All patients received orthotic braces. Treatment progress was monitored bimonthly using 3D scanning to measure the External Haller Index. Outcomes included correction success, treatment duration, complication rates, adherence, and patient/parent satisfaction assessed via the Pectus Carinatum Evaluation Questionnaire (PCEQ).

Results

Final success rates were comparable between the low-intensity and high-intensity groups (86.3% vs. 89.8%, p>0.05), with no significant difference in median correction time (7.5 ± 0.8 months vs. 7.3± 0.9 months, p=0.321). The high-intensity group showed significantly greater EHI improvement at the 2-month follow-up (1.24 ± 0.11 vs.1.18 ± 0.13, p<0.05), but this difference disappeared by 4 months(1.27± 0.08 vs.1.25 ± 0.09, p=0.093). The low-intensity group demonstrated significantly better treatment compliance (95.6% vs. 89.1%, p<0.05) and higher post-treatment satisfaction scores (4.5±0.3 vs. 4.2±0.4, p<0.05). Complication rates were low overall (7.2%) and predominantly mild, with slightly fewer complications in the low-intensity group. One case (0.5%) of recurrence was successfully managed with brief resumed bracing.

Conclusion

A low-intensity bracing regimen achieves long-term correction efficacy comparable to a high-intensity regimen without prolonging treatment duration, while significantly improving patient compliance and satisfaction. The use of 3D scanning to standardize initial corrective pressure provides an objective benchmark for pressure adjustment. These findings support a paradigm shift towards patient-centered, low-intensity bracing strategies for pediatric PC, prioritizing tolerability and adherence to optimize overall outcomes.