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LOCpectus non-surgical treatment for Pectus

The London Orthotic Consultancy's treatment for pectus deformities involves wearing a bespoke brace in combination with a programme of exercises.

 

LOCpectus non-surgical treatment for Pectus

The London Orthotic Consultancy's treatment for pectus deformities involves wearing a bespoke brace in combination with a programme of exercises.

 

LOCpectus Treatment

Pioneering Non-Surgical treatment

The London Orthotics Consultancy’s non-surgical treatment for pectus excavatum and pectus carinatum involves wearing a bespoke brace, or orthosis, called a 'Dynamic Chest Compressor', in combination with a programme of daily exercises. We call our treatment programme LOCpectus.

During treatment, we monitor the progress by reviewing the patient both at our clinic and also on Skype. We must constantly monitor and adjust the Dynamic Chest Compressor to ensure the correct correctional forces are being applied.

At each physical appointment, we will check that the brace is positioned correctly and that the correction pads are designed correctly for your changing chest shape. We realise that there is a huge commitment required from you to wear the brace and we want every moment that you wear it to be as effective as possible.

For patients considering LOC’s non-surgical treatments for pectus excavatum and pectus carinatum, the initial consultation is FREE with no obligation to proceed. During the consultation one of LOC's clinicians will examine your chest and also your general posture. They will look at your alignment from head to toe if required, looking for signs of asymmetry.

Length of Treatment

Generally, we define the result and the time to finish treatment by your own opinion of how your chest looks. The majority of our patients enter into the treatment because they are not happy with their chest shape. Therefore, we want you to be happy with the end result. This may range from you feeling comfortable enough to take your shirt off in public, or that you may simply no longer be aware of any deformity under your clothes. This is a very personal decision, but we will help to guide you through it.

When treating patients with flexible chest walls, we have to be careful not to over-correct as some patients can show significant improvement within the first three weeks, hence the need for regular appointments in the early stages.

To finish treatment, we generally need our patients to wear the brace in an ever-reducing 'wearing protocol'. For patients still growing, we will need to maintain treatment at some level until we are happy that an individual's growth has stopped. This may mean wearing the brace a couple of times a night during the week and continuing with daily exercises.

On average, we would expect to have a positive outcome from treatment within a year. Once the treatment is complete and you have stopped growing, the deformity will not return.

Stretching and Breathing Exercise Compliance

Some patients may find the initial stages of treatment tough. The first few days can be painful, as the corrective force to the chest is applied, and the first few weeks may be uncomfortable. After that, our patients normally say that they feel odd when they take the brace off. We encourage our patients to be open with family and friends, so that they can be a source of encouragement in the early days of treatment.

Part of our treatment plan incorporates a daily exercise routine of roughly 30-40 minutes of stretching using latex resistance bands, yoga poses, deep breathing exercises and general stretching of the chest area. Deep breathing exercises allow the lungs to expand against the chest wall, pushing it outwards.

Swimming is also a great way to exercise when you are undergoing treatment for pectus deformity, as the stretching required to swim imitates the latex band exercises designed specifically to stretch your chest and increase its flexibility. Also, if you are doing backstroke or front call, you are taking deep breaths which promote chest wall correction. (Note: swimming butterfly stroke is not recommended as it can compound the problem when the arms swing together and compress the chest).

Regular reviews are part of the treatment programme, preferably in clinic, or via Skype consultations.

The treatment programme still demands a high level of patient compliance to succeed but is the key to achieving a good result. We will help and encourage our patients as much as possible, but, ultimately, success will be determined by the patient themselves. Hopefully, they will seek encouragement to 'stick with it' from family and close friends.

Dynamic Chest Compressor

 Dynamic Chest Compressor

The London Orthotic Consultancy’s treatment programme (LOCpectus) for pectus carinatum and pectus excavatum involves wearing a bespoke brace – the Dynamic Chest Compressor. When treating pectus excavatum specifically, we use this in conjunction with the ‘Vacuum Bell’ below.

When you’re treating pectus excavatum, the chest does not protrude so you do not need a compressor for the main area, but there are often still flared ribs so we add pressure to them to correct the overall chest shape. Sometimes rib flaring can be significantly contributing to the excavatum and without correcting it, the overall result is often not satisfactory.

We use an exercise program in conjunction with the dynamic chest compressors to achieve the best possible correction. We will often use two types of dynamic chest compressor; the first to target the main sternum area and the dynamic chest compressor, the second to work on the flared ribs that are stereotypical of pectus deformity.

The Dynamic Chest Compressor is a custom-made orthosis that is designed to an individual’s anatomy and to specifically treat their particular type of deformity. Its objective is to apply pressure over areas of the skeleton to remodel chest and rib bones. This concept of bone remodelling is called Wolfe’s Law and is used in dentistry where braces are used to remodel the jaw. The brace applies constant pressure over the area of the chest that needs to be remodelled.

The Dynamic Chest Compressor can be worn under clothing and in most cases is difficult to see even if you have to wear two. However, it is not entirely invisible through thin clothing. If you are concerned about the appearance of the braces, please discuss this with your clinician. We can go through strategies to help you deal with wearing the brace. Over the years one thing has been very clear to us. Any anxiety that exist with regard to wearing the brace is often short lived as most people will not notice you have it on.

The brace is designed so it can be adjusted through growth and as your chest shape improves. We will try to keep it as slim fitting as possible and adjust it at your regular appointments.

 

The Vacuum Bell

The Vacuum Bell

The Vacuum Bell was invented by Eckart Klobe, graduate in Chemical Engineering; and has been used successfully in the treatment of Pectus Excavatum by a number of German, Austrian and Swiss clinics over the last decade. LOC has added the Vacuum Bell to its LOCpectus treatment programme for pectus excavatum. The Bell works by using a silicone suction cup and a vacuum pump to create an area of low pressure over the anterior chest wall, and lifts the sternum excavatum area up and out. The dynamic chest compressor brace is used with the vacuum bell to enhance that correction and to correct rib flaring.

At LOC we see the best results when the Vacuum Bell treatment is combined with the brace and exercise programme. LOC’s advice is to wear the cup immediately after the completion of the daily exercise regime. This is when the chest should be at its most flexible and along with the brace will maximise the effect of the correctional forces of the Bell.

The combined treatment programme will be thoroughly explained at the initial FREE consultation