Evaluation of the treatment of pectus carinatum with compressive orthotic bracing using three dimensional body scans

Published:February 05, 2014DOI:



      The purpose of this study is to measure the effectiveness of compressive orthotic brace therapy for the treatment of pectus carinatum using an adjusted Haller Index (HI) measurement calculated from 3D body scan (BS) images.


      Pediatric patients with pectus carinatum were treated with either compressive orthotic bracing or observation. An adjusted BS Haller index (HI) was calculated from serial 3D BS images obtained on all patients. Medical records were evaluated to determine treatment with bracing and brace compliance more than 12 hours daily. Compliant patient measurements were compared to non-compliant and non-brace groups.


      Forty patients underwent compressive orthotic bracing, while ten were observed. Twenty-three patients were compliant with bracing, and seventeen patients were non-compliant. Compliant patients exhibited an 8.2% increase, non-compliant patients had a 1.5% increase, and non-brace patients exhibited a 2.5% increase in BS HI. The change in BS HI of compliant patients was significantly different compared to non-brace patients (p = 0.004) and non-compliant patients (p < 0.001).


      Three dimensional BS is an effective, radiation free, and objective means to evaluate patients treated with compressive orthotic bracing.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Pediatric Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Haje S.A.
        • Harcke H.T.
        • Bowen J.R.
        Growth Disturbance of the Sternum and Pectus Deformities: Imaging Studies and Clinical Correlation.
        Pediatr Radiol. 1999; 29: 334-341
        • Egan J.C.
        • DuBois J.J.
        • Morphy M.
        • et al.
        Compressive Orthotics in the Treatment of Asymmetric Pectus Carinatum: A Preliminary Report with an Objective Radiographic Marker.
        J Pediatr Surg. 2000; 35: 1183-1186
        • Stephenson J.T.
        • Du Bois J.D.
        Compressive Orthotic Bracing in the Treatment of Pectus Carinatum: the use of Radiographic Markers to Predict Success.
        J Pediatr Surg. 2008; 43: 1776-1780
        • Lee S.Y.
        • Lee S.J.
        • Jeon C.W.
        • et al.
        Effect of the Compressive Brace in Pectus Carinatum.
        Eur J Cardiothorac Surg. 2008; 34: 146-149
        • Banever G.T.
        • Konefal S.H.
        • et al.
        Nonoperative Correction of Pectus Carinatum with Orthotic Bracing.
        J Laparoendosc Adv Surg Tech. 2006; 16: 164-167
        • Kravarusic D.
        • Dicken B.J.
        • Dewar R.
        • et al.
        The Calgary Protocol for Bracing of Pectus Carinatum: A Preliminary Report.
        J Pediatr Surg. 2006; 41: 923-926
        • Haje S.A.
        • Bowen J.R.
        Preliminary Results of Orthotic Treatment of Deformities in Children and Adolescents.
        J Pediatr Orthop. 1992; 12: 795-800
        • Haller J.A.
        • Kramer S.S.
        • Lietman S.A.
        Use of CT Scans in Selection of Patients for Pectus Excavatum Surgery: A Preliminary Report.
        J Pediatr Surg. 1987; 22: 904-906
        • Frey A.S.
        • Garcia V.F.
        • Brown R.L.
        • et al.
        Nonoperative Management of Pectus Carinatum.
        J Pediatr Surg. 2006; 41: 40-45
        • Piccolo R.L.
        • Bongini U.
        • Basile M.
        • et al.
        Chest Fast MRI: an Imaging Alternative on Pre-operative Evaluation of Pectus Excavatum.
        J Pediatr Surg. 2002; 47: 485-489
        • Poncet P.
        • Kravarusic D.
        • Richart T.
        • et al.
        Clinical Impact of Optical Imaging with 3-D Reconstruction of Torso Topography in Common Anterior Chest Wall Anomalies.
        J Pediatr Surg. 2007; 42: 898-903