Pioneering Non-Surgical Pectus 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, we offer a free Skype consultation where our clinician will explain our treatment package and assess whether it is likely to be a suitable treatment for your particular condition. If you jointly agree that treatment will be worthwhile an initial face-to-face consultation will be arranged. At this consultation one of our clinician’s will, among other things, assess the flexibility of your chest wall and take 3D scans and photographs of it.
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
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 is called Wolfe’s Law and is used in dentistry where braces are used to remodel the jaw.
The “Vacuum Bell” was invented by Eckart Klobe, a graduate in Chemical Engineering; it has been used successfully in the treatment of Pectus Excavatum by a number of German, Austrian and Swiss clinics over the last decade. The Bell works by using a silicone cup and a vacuum pump to create an area of low pressure over the sunken part of the chest. LOC’s advice is to wear the cup immediately after the completion of the daily exercise programme. This is when the chest should be at its most flexible and will maximise the effect of the correctional forces of the Bell.