Re: pectus carinatum
Paula Pivko
Description
Collection
Title:
Re: pectus carinatum
Creator:
Paula Pivko
Date:
5/6/2022
Text:
Hi and thanks to everyone for responding to my question. The client has decided to seek a second opinion on pricing. Meanwhile, the reviews on the truLife brace were mixed, with most saying it was fine for average males with fairly normal anatomy. Others said custom was better and less bulky; the TruLife needed a lot of adjusting. Given the boy's height and weight, I would probably have gone custom. Spinaltech was mentioned as a source for a custom orthosis and X-rays are usually not necessary. Here are the responses. Paula Martinek, LPO
Not sure this will be helpful but I'd suggest x-rays may not be necessary nor helpful as the additional detail would not influence the treatment, as the outcome is largely cosmetic, subjective. You should receive additional manufacturer recommendations, aside from Trulife. Some designs utilize rigid side bands, intended to bridge the ribs, typically made to tracings and measures. Others like Trulife, use flexible straps that contact ribs.
I have fit tons of Pectus Orthoses over the years as well as helped design the Trulife OTS Pectus Orthosis. To answer your question, it would depend on the position of the deformation whether you would choose an OTS over a custom orthosis. Also, is your patient female or male? I did a very specific custom design for my female patients. The anterior pad needs to be directly over the apex of the deformation to get good outcomes as well as you would need to determine how flexible the Pectus Carinatum is. If you can take the palm of your hand and physically depress the deformity you will most likely have good outcomes. Of course, it will also be determined by the wear time of your patient. I also never had X-rays taken. I used a scanner throughout the patient care to show clinical improvements, very similar to what is done when showing scanned improvements on a cranial patient.
Totally understand you're looking for a more cost-effective option for the patient. However, I don't think you'll have to sacrifice much on price by still staying 100% custom - our Pectus Brace at Protosthetics is 100% 3D scan to 3D print so it perfectly fits the patient, and starts at $450: <URL Redacted>
Our experience with the TruLife braces is that they can be a serious discomfort for kids, and they end up asking their practitioners for a lot of adjustments over time. Ours usually fits right after the first fitting.
I've used the trulife one in the past. I feel like it's every bit as good as a custom. You can also retrofit with a custom sternal pad.
I hope this helps,
We offer the T-Joe Pectus Brace, can be ordered using the Structure Sensor and App - Pectus Scan from the apple app store.
Feel free to call the office with questions or pricing.
Regards,
Joe & Staff Pectus Services
PectusServices.com Phone: 877-732-8876 Intl: 011-973-488-7184 Fax: 973-488-7185
True life is fine – just a bit bulkier than custom. You need to make sure the pectus is COMPLETELY reduced while wearing it – assure family it is a return to normal alignment and not putting pressure on lungs/heart. You may need to add over the shoulder straps to prevent distal migration of orthosis.
I have done a lot of these. The TruLife is the way to go . As long as the patient is a young male, the area is in the center of the chest. You should have no issue.
Compliance is the key to success. The patient must wear 24 /7 in the beginning.(6 months) You should document progress by taking a/p measurements at each followup.
I would follow 2 week after the fitting ,then every month.( Price your brace accordingly. There is no code for this.Your time is worth something)
Each time they remove the brace the protrusion will go back. After 6months if significant progress has been made ,they sleep with it for another 6 months.
The TruLife is low profile and easy to customize. I have added shoulder straps on several cases and extra padding . No need for custom.
It does work as long as the patient is willing.
Hope this helps
Hi Paula. I’ve fit a ton of the trulife pectus and they are great. Easily adjustable and modifiable. Hope that helps.
Unless the patient is very abnormal, the trulife ones normally work just fine. I normally use them unless order specifically ask for custom or patient has abnormal anatomy.
We do quite a bit of pectus bracing in our clinic and I find the Trulife brace to be uncomfortable and ill fitting for most people. If you are going to use an off the shelf (which I would only do if the patient is very mild, symmetrical, and flexible) I would take a look at the EmBrace. A custom pectus brace through Protosthetics is what we typically use. If you have questions feel free to reach out to me. Management of this type of deformity is very different from scoliosis and doesn't typically require many x-rays as it is a cosmetic issue involving cartilage.
Not sure this will be helpful but I'd suggest x-rays may not be necessary nor helpful as the additional detail would not influence the treatment, as the outcome is largely cosmetic, subjective. You should receive additional manufacturer recommendations, aside from Trulife. Some designs utilize rigid side bands, intended to bridge the ribs, typically made to tracings and measures. Others like Trulife, use flexible straps that contact ribs.
I have fit tons of Pectus Orthoses over the years as well as helped design the Trulife OTS Pectus Orthosis. To answer your question, it would depend on the position of the deformation whether you would choose an OTS over a custom orthosis. Also, is your patient female or male? I did a very specific custom design for my female patients. The anterior pad needs to be directly over the apex of the deformation to get good outcomes as well as you would need to determine how flexible the Pectus Carinatum is. If you can take the palm of your hand and physically depress the deformity you will most likely have good outcomes. Of course, it will also be determined by the wear time of your patient. I also never had X-rays taken. I used a scanner throughout the patient care to show clinical improvements, very similar to what is done when showing scanned improvements on a cranial patient.
Totally understand you're looking for a more cost-effective option for the patient. However, I don't think you'll have to sacrifice much on price by still staying 100% custom - our Pectus Brace at Protosthetics is 100% 3D scan to 3D print so it perfectly fits the patient, and starts at $450: <URL Redacted>
Our experience with the TruLife braces is that they can be a serious discomfort for kids, and they end up asking their practitioners for a lot of adjustments over time. Ours usually fits right after the first fitting.
I've used the trulife one in the past. I feel like it's every bit as good as a custom. You can also retrofit with a custom sternal pad.
I hope this helps,
We offer the T-Joe Pectus Brace, can be ordered using the Structure Sensor and App - Pectus Scan from the apple app store.
Feel free to call the office with questions or pricing.
Regards,
Joe & Staff Pectus Services
PectusServices.com Phone: 877-732-8876 Intl: 011-973-488-7184 Fax: 973-488-7185
True life is fine – just a bit bulkier than custom. You need to make sure the pectus is COMPLETELY reduced while wearing it – assure family it is a return to normal alignment and not putting pressure on lungs/heart. You may need to add over the shoulder straps to prevent distal migration of orthosis.
I have done a lot of these. The TruLife is the way to go . As long as the patient is a young male, the area is in the center of the chest. You should have no issue.
Compliance is the key to success. The patient must wear 24 /7 in the beginning.(6 months) You should document progress by taking a/p measurements at each followup.
I would follow 2 week after the fitting ,then every month.( Price your brace accordingly. There is no code for this.Your time is worth something)
Each time they remove the brace the protrusion will go back. After 6months if significant progress has been made ,they sleep with it for another 6 months.
The TruLife is low profile and easy to customize. I have added shoulder straps on several cases and extra padding . No need for custom.
It does work as long as the patient is willing.
Hope this helps
Hi Paula. I’ve fit a ton of the trulife pectus and they are great. Easily adjustable and modifiable. Hope that helps.
Unless the patient is very abnormal, the trulife ones normally work just fine. I normally use them unless order specifically ask for custom or patient has abnormal anatomy.
We do quite a bit of pectus bracing in our clinic and I find the Trulife brace to be uncomfortable and ill fitting for most people. If you are going to use an off the shelf (which I would only do if the patient is very mild, symmetrical, and flexible) I would take a look at the EmBrace. A custom pectus brace through Protosthetics is what we typically use. If you have questions feel free to reach out to me. Management of this type of deformity is very different from scoliosis and doesn't typically require many x-rays as it is a cosmetic issue involving cartilage.
Citation
Paula Pivko, “Re: pectus carinatum,” Digital Resource Foundation for Orthotics and Prosthetics, accessed April 29, 2024, https://library.drfop.org/items/show/255914.
