Summary

Pectus carinatum (PC) or “pigeon chest” is a deformity of the thoracic cage, consisting of an anterior protrusion at the costo-sternal level characterised by excessive growth of the costal cartilage. Its prevalence is approximately one per every 1500 live births, and in most cases correction of PC is performed for aesthetic reasons, since only on rare occasions is it associated with physical symptoms. Traditionally, open surgery has been the treatment of choice, though in the last decade interest in non-invasive treatments using chest orthoses (braces) has been on the increase because, compared to surgery, orthotic treatment eliminates the risks posed by anaesthesia and
surgery, thus reducing the complication rate and costs. These braces can be either conventional (system fitted with two valves, which enable pressure to be exerted on the protrusion) or dynamic (conventional system fitted with an electronic device that enables the pressure to be monitored and adjusted).

Objective. To assess the safety and effectiveness of non-invasive treatment of PC using conventional and dynamic compression brace systems on children and adolescents.

Material and methods. We conducted a systematic review of the literature, with a search in January 2015 that covered: systematic reviews databases, such as Health Technology Assessment (HTA), Database of Abstracts of Reviews of Effectiveness (DARE), Economic Evaluation Database of the National Health Service (NHS EED) and the Cochrane Library Plus; and general mdical databases, such as Medline, Embase and the ISI Web of Science. The studies retrieved were selected in accordance with a set of predefined criteria and reviewed by two independent reviewers.

Results, discussion and conclusions: see pdf summary below