In Memoriam – Dr. Sydney A. Haje | Clinical Center Orthopectus

Dr. Sydney Haje - Centro Clínico Orthopectus

Dr. Sydney Haje

CRM-DF 2666

Founder and creator of ORTHOPECTUS Clinical Center, and was instructor of Pediatric Orthopedics in Brasilia, DF, Brazil. His study and research interests included growth disorders and abnormalities of the spine and chest , emphasizing the deformities pectus carinatum and pectus excavatum. Since 1977, developed a conservative treatment by the use of orthotics and exercises, the Dynamic Method of Remodeling (DR ) method, proving that pectus deformities can be treated without surgery, if basic orthopedic principles are followed .

Perhaps an obituary written by a son who closely followed the personal and professional life of his father may be slightly different and longer than others. My father, my best friend, my pal, my mentor in Orthopedics, my majority partner, my colleague in publications and book chapters, the best father in the world for me and my sister. Always on his side was the most exemplary and committed partner he could ever have, his wife, my mother, who managed our clinic and his personal life, who was always strong, who was recognized by him as possessing unique qualities, who helped him grow and mature as a human being and professional. I am glad to see that my father was very happy with my mother, with his children and grandchildren, besides his countless friends. I could write page after page about his personal virtues, but I am going to stick to his professional achievements, of which we are quite proud.

Born in Anápolis-GO, he moved out to Brasília in 1969 to complete his studies, and graduated in Medicine in 1976 from the University of Brasilia (Unb). He undertook his medical residency training in Orthopedics at the Sarah Hospital. He also achieved a specialization degree in Physical Therapy.

His great legacy in Medicine was the creation of a conservative treatment protocol for chest-wall deformities. His first patient was treated 35 years ago, when he created the DCCI I brace and later the DCC II, in connection with a protocol of specific exercises (Dynamic Remodeling Method), which set new standards for the treatment of pectus carinatum and excavatum, and brought the treatment of these disorders, previously treated by thoracic surgeons only, into the branch of Orthopedics. The number of patients with pectus who was registered and photographed with amazing organization was nearly five thousand.

As a pioneer, he described in his papers the different types of pectus; he pointed out that, for each type of pectus, there is a treatment prognosis and an ideal age for beginning treatment; he demonstrated that the flexibility of the chest wall is variable and that treatment also relies on that factor. He showed that, for any treatment using a chest brace, a physician needs to have a great deal of sensitivity, which he had more than enough.

In addition to treating these deformities, he studied their prevalence amid our population and showed their association with some respiratory and spinal conditions. He pioneered the replication of these deformities in an experiment at the Alfred I. Dupont Institute in the USA, showing that, instead of the previously described sutures between sternal segments, there are actually growth plates, which proves that both carinatum and excavatum are caused by genetically determined growth disorders on those plates. It was the Journal of Pediatric Orthopaedics that introduced his first international paper, among other 23, on the topic of pectus. He was the first to describe, in the International Orthopaedics Journal, the possibility of iatrogenic pectus following cardiac surgery associated with stenortomy in an immature skeleton, due to an injury on growth plates. The radiology of the thoracic skeleton was not neglected, he demonstrated, in innovative and awarded papers (Caffey Award Paper) published in Skeletal Radiology and Pediatric Radiology, what happened to the manubrium, sternum and costal cartilages in patients with pectus. He created radiographic indices and also described for the first time several tomographic findings, making their correlation with the different types of pectus. He reported, in International Orthopaedics, the possibility of hypercorrection of pectus deformities with a treatment devised by him and the way to manage these complications, the outcomes from a more than effective treatment. He had the pleasure to describe in detail his treatment in a chapter of a Portuguese-language book that became a reference for Brazilian orthopedists. A treatment that was constantly evolving. Today, if he were to write a new chapter, he would show his latest innovations in the treatment of pectus, details often made a substantial difference in a successful treatment.

His method was renowned all over the world. His colleague, Dr. Andre Hebra, professor of Pediatric Surgery at the University of South Carolina, wrote the following email to the scientific community a few days ago: “The surgical community across the world is mourning the loss of Dr. Haje. His creative and visionary mind will forever be a source of inspiration for medical professionals, particularly surgeons that care for children. Thanks to his dedication and devotion to patients affected by congenital chest wall malformations, he was able to revolutionize the management of pectus deformities, bringing to the forefront creative treatment options that provided cure without surgical intervention. His unselfish nature allowed for the quick dissemination of his treatment techniques across the world, bringing the brace treatment to all continents. Without any doubt, thousands of children all over the world have already benefited from Dr. Haje's treatment interventions. Our surgical community will, as he was, continue to be committed to the dissemination of his treatment techniques to the benefit of countless number of patients. Dr. Haje will always be remembered by all of us with great admiration and respect. We share with his family the great sadness of the premature loss of his life. However, we are confident that the many patients that have benefited from his work and the many more that will benefit in the future from his techniques will place him on a special pedestal for medical innovators that will never be forgotten.”

He gave lectures on his treatment method in the USA, England, Canada, Turkey, Argentina, Croatia, Spain, Mexico, and Russia. His method was considered revolutionary in England and has been adopted in that country with his name. Dr Sydney A. Haje was one of the main speakers at the latest meetings of the Chest Wall Interest Group (CWIG). He was not upset at all for not patenting his discovery. He used to say it was better this way. In his papers and lectures, he insisted on showing details of his treatments, so that other colleagues could replicate his method.

I don’t know why, but he always said that his latest paper would be the final one. In his last article, he described for the first time a simultaneous conservative treatment of chest deformities and severe scoliosis and showed the results of his Brasilia Bending Brace. In my view, this will become another contribution to Orthopedics when studied with a larger number of cases and longer follow-up time.

He helped needy patients in Brasilia by starting the first conservative treatment program for pectus in the Brazilian public health system, in 1995, and managed to have the DCC I and II braces given out for free in Distrito Federal since then. By coincidence, on the day and at the time of his passing, a local TV show was showing patients being given DCC braces for free in a government’s orthopedic workshop.

He planned to keep on treating thousands of patients who hailed from all over Brazil and the world and intended to continue teaching around the world. In September, he would probably go to Lebanon to give a lecture. In November, he was likely to head for London for a one-week course. He used to say he would go to South Korea for the next CWIG meeting in 2013.

He was always very active at the Brazilian Orthopedics Society of Distrito Federal. He presided over that society for two biennia in a row and reformulated it, making it stronger. As of late, he actively participated in the Medical Association of Brasília (AMBr), for which he was the scientific director and director of continued medical education.

On the saddest day of my life, I found my father’s body without material life in front of his computer, through which he replied to daily questions from patients, in addition to writing scientific papers. He had just written his last two words before his heart stopped beating all of a sudden. I saw, for the very first time, a scientific paper on the work of his professional life, on pectus, without his name, containing only my own name, maybe it was a divine sign that, by then, he had already done all he needed to do on Earth.

For details of his CV, scientific publications and international awards, see the website www.orthopectus.com.br. For his last interview, in which he speaks about his method in detail, see video.

Prof. Dr. Davi P. Haje or his son Davi
Published paper about pectus and scoliosis
  • Haje SA, Haje DP, Martins GEV, Ferrer MG (2011)

    The spine lateral bending and the dynamic chest compression principles for concomitant orthotic treatment of scoliosis and pectus deformities

    Os princípios da inclinação lateral da coluna e compressão dinâmica do tórax para tratamento ortótico concomitante da escoliose associada a deformidades pectus

    Click Here e confira online.

  • Haje SA, Haje DP, Silva Neto M, Cassia GS, Batista RC, Oliveira GRA, Mundim TL (2010)

    Pectus deformities: tomographic analysis and clinical correlation

    Skeletal Radiology, Vol. 39/8: 773-782.

    Click Here e confira online.

  • Haje SA, Haje DP (2009)

    Abordagem ortopédica das deformidades pectus: 32 anos de estudos

    Orthopaedic approach to pectus deformities: 32 years of studies

    Revista Brasileira de Ortopedia; Vol 44/3: 193-200.

    Click Here e confira online.

  • Haje SA, Haje DP (2009)

    Tórax e Cintura Escapular. In Hebert, S.K.; Barros Filho T.E.P..; Xavier, R.; Pardini Jr. A. G. – Ortopedia e Traumatologia: Princípios e Prática

    4ª Edição - Porto Alegre: Artmed Editora, p. 147-165.

  • Haje SA, Haje DP, Guerra JB, Petrenko Jr AG (2008)

    Órtese inclinada de uso contínuo e exercícios para tratamento da escoliose idiopática: uma nova proposta

    Day and night bending brace and exercises for treatment of idiopathic scoliosis: a new proposal.

    Brasilia Med; 45(1):10-20.

  • Haje SA, Haje DP (2007)

    Tratamento conservador e reabilitação de pacientes com deformidades pectus: uma experiência de 29 anos

    Non-surgical treatment and rehabilitation of patients with pectus deformities: a 29 years experience

    Medicina de Reabilitação, vol 26/1: 1-6

  • Haje SA, Haje DP (2006)

    Overcorrection during treatment of pectus deformities with DCC orthoses: experience in 17 cases

    International Orthopaedics (SICOT), 2006, vol. 30/4: 262-267

    Click Here e confira online.

  • Haje, S. Tórax e Cintura Escapular (2003)

    In Hebert, S.K.; Xavier, R.; Pardini Jr. A. G.; Barros Filho T.E.P - Ortopedia e Traumatologia: Princípios e Prática

    3ª ed. Porto Alegre: Artmed Editora, p. 161-184.

  • Haje DP, Haje SA, Simioni MA. (2002)

    Prevalência das deformidades pectus carinatum e pectus excavatum em escolares do Distrito Federal

    Prevalence of pectus carinatum and pectus excavatum deformities in scholars of the Federal District, Brazil

    Brasília Médica vol. 39 (1/4): 10-15.

  • Haje SA, Harcke HT, Bowen JR (1999)

    Growth disturbance of the sternum and pectus deformities: imaging studies and clinical correlation

    Pediatric Radiology vol. 29: 334-341.

    Click Here e confira online.

  • Haje SA, Bowen JR, Harcke HT, Guttenberg ME, Bacon CR (1998)

    Disorders in the sternum growth and pectus deformities: an experimental model and clinical correlation

    Acta Ortop Bras 6: 67-75

  • Haje SA (1996)

    Pectus carinatum iatrogênico (pós-cirurgia cardíaca pediátrica): resultados do tratamento ortótico-ortopédico-fisiátrico

    Brasília Médica, Vol 33: 93-99.

  • Haje SA (1995)

    Iatrogenic pectus carinatum: a case report

    International Orthopaedics (SICOT), Vol 19/6:370-373.

  • Haje SA (1995)

    Carta ao editor a respeito do artigo / Letter to the editor regarding the article: Pectus Carinatum succesfully treated with bracing – A case report, publicado em / published in

    International Orthopaedics (1993) Vol 17:350-352, por / by Mielke CH and Winter RB. International Orthopaedics (SICOT), Vol 19/5:332-333.

  • Haje SA (1995)

    Deformidades pectus: novos conceitos e abordagem ortopédica em crianças e adolescentes – 1ª parte

    Revista Brasileira de Ortopedia, Vol 30/1,2:75-79.

  • Haje SA (1995)

    Deformidades pectus: novos conceitos e abordagem ortopédica em crianças e adolescentes – 2ª parte.

    Revista Brasileira de Ortopedia, Vol 30/3:143-149.

  • Haje SA (1994)

    VIDEO-TAPE: Deformidades torácicas sob um ponto de vista ortopédico: novos conceitos. Dublagem para o português da fita abaixo (ref. 11).

    Biblioteca de video-tapes da Sociedade Brasileira de Ortopedia e Traumatologia – SBOT.

  • Haje SA (1994)

    VIDEOTAPE: Pectus deformities from an orthopaedic standpoint: new concepts. Orthopaedic Surgery Videotape Library (fita número / tape # 24-116, catálogo de 1994/95 / 1994/95 catalogue)

    American Academy of Orthopaedic Surgeons – AAOS – Award Winner (Premiado). ATTENTION: tape not available anymore.

  • Haje SA (1993/94)

    Pectus deformities from an orthopaedic standpoint. Orthopaedic Transactions

    The Journal of Bone and Joint Surgery, Vol 17/4:977-978.

  • Haje SA (1993)

    VÍDEO-TAPE: Etiopatogenia e tratamento das deformidades torácicas: novos conceitos.

    Biblioteca de video-tapes médicos da Associação Médica de Brasília (AMBr) – Trabalho Premiado no III congresso da AMBr.

  • Haje SA, Bowen JR (1992)

    Preliminary results of orthotic treatment of pectus deformities in children and adolescents.

    Journal of Pediatric Orthopaedics, Vol 12:795-800

  • Haje SA, Antunes EJ, Raymundo JLP, Dourado JN (1988)

    Pectus Carinatum: enfoque atual.

    Revista Brasileira de Ortopedia, Vol 23/9:257-264.

  • Haje SA, Raymundo JLP (1979)

    Considerações sobre deformidades da parede torácica anterior e apresentação de tratamento conservador para as formas com componentes de protrusão.

    Revista Brasileira de Ortopedia, Vol 14/4:167-178.

Non pectus published papers:

  • Haje DP, Haje SA, Porto AO, Silva CFV (2005)

    Sutura percutânea do tendão calcâneo pela técnica de Ma e Grffith modificada: avaliação dos resultados / Percutaneous suture of Achilles tendon by modified Ma-Griffith technique: results’ evaluation

    Revista Brasileira de Ortopedia, Vol 40/4:162-174.

  • Haje SA (1996)

    Luxação congênita do quadril na síndrome da maquilagem Kabuki: relato de caso

    Revista Brasileira de Ortopedia, Vol 31/1:46-49.

  • Vidigal EC, Haje SA, Garcia CR, Medeiros TO (1996)

    Fractures of the femoral neck area in children: a retrospective analysis of results

    Orthopaedics International Edition, Vol 4/1:27-33.

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