Milwaukee brace responses.
Polglase, John K
Description
Collection
Title:
Milwaukee brace responses.
Creator:
Polglase, John K
Date:
4/23/2001
Text:
Thanks to all of you who responded to this question. A summary of responses.
Regards
John.
.Dear John, The Milwaukee Brace may not ever be in vogue again and thank
God for that, but it is still a good choice for superior curves (above T 8)
for compliant (a rare breed)! patients.
John-
What is the apex of the curve? I've done a lot of scoly work the last few
years, and in that time, I've only done one Milwaukee brace. Keep in mind
that T8 is a textbook value for the exam. I have successfully braced kids at
T6 or T7 with a Boston style TLSO.
I my continuing experience, they are very much in vogue in the States and
abroad, with minor variations. There is some evidence that thoracic
curves don't correct well with any brace, but the Milwaukee and its
variants are the only brace available if bracing is the route being
travelled. The Milwaukee Brace by Blount and Moe might still be the
definitive book on the subject, though written some 30 years ago,
covering fabrication and theory. The priniciples haven't changed much.
John,sorry to hear that you had such little response. Although I am
currently out of clinical practice, the treatment of scoliosis was always a
big part of my practice and has always held special interest for me. I am
not aware of any courses currently being offered on the Milwaukee brace,but
I beleive it is still the gold standard for treating curves above T-8. The
best book on the Milwaukee brace is still Blount's book entitled The
Milwaukee Brace. I do not know where to find it these days but maybe
someone elseWe use the boston type orthosis with the idea that with better
compliance if
we get the lower curves supported the top curves will be more stable. Who
even knows if scoli bracing works long term at all or enought to put the
kids through it.
Dear John, I'm using for curves on the coronal or sagital plane a CTLSO,
could be with the regular neck ring ( Milwaukee Brace) or Low profile neck
ring.
To me the CTLSO is the most appropiate brace to traet curves above T8.
I'm sorry I didn't read your first E. Mail. What do you want to know about
Milwaukee Brace?, Maybe I can share my ideas and Experince.
At Connecticut Children's Medical Center, we are using the Boston Brace for
curves w/ an apex as high as T 7. We use a nocturnal brace called the
Providence for double curves w/ an apex as high as T 6. We do still use
Milwaukee's- some with a low profile neck ring as opposed to the
superstructure. To complete the picture of Idiopathic Scoli bracing at our
facility, we generally use the Charleston for single Thoracic and single
Thoracolumbar apical curves. Hope this helps.
For treating patients with Apices of T8 or above, we do a modified Milwaukee
type brace, with a neck rings rather than the very high superstructure. The
main problem here is compliance. The large superstructure is CLEARLY
visible
through the clothes and compliance is very low - especially the older the
child you are trying to treat.
The neck ring is much lower in profile and provides some of the leverage
principles inherent to the Milwaukee. As far as the success between one and
the other - I believe that at least with the neck ring, there is SOME chance
the patient will be wearing it and benefitting from it. When it comes to
the
Milwaukee, I don't know what to believe.
If you wish to see what I'm talking about, the low profile neck ring is
available through Fillauer. If you need any more information, I'd be happy
to help you in any way I can.
Take care and good luck
This is very true. In cases of paralytic or neuromuscular imbalance
realted scoliosis, the Milwaukee requires active pulling away form the
corrective pad and is not at all recommended. We use a total contact
TLSO, either hard shell with cutouts or soft circumferential in these
cases.
We have noticed a significant decrease in bracing in just the last 5
years. Seems the physicians are interviening surgically much earlier
than before. The Milwaukee is still the orthosis of choice if the curve
is above T8. Or adding a Milwaukee type super structure to a Boston
type jacket.
Good Luck,
As far as I know, only the Milwaukee. I don't need to use very often. So
far, I have been able to use the low profile neck ring on the ones I have
done, which makes it more livable. You can get the low profile neck ring
from Fillauer.
BOSTON OVERLAP OR NIGHT BENDING TLSO
Houston still uses quite a few Milwaukee CTLSOs for curves with apices
superior to T-8.
Probably many folks on the OANDP-L never saw a Milwaukee brace for scoli
treatment. In the U.S. Air Force, we stopped using Milwaukees about 20+
years
ago, in favor of the Boston Brace (with neck ring and superstructure if
needed
for high curves) I don't see a web site on a note pad I have from them, but
the
address is:
Boston Brace International, Inc.
20 Ledin Drive
Avon, MA 02322
FAX: 508 587-8119
(800) 262-2235
FWIW, I have had limited success with curves above T8 by leaving the Boston
Brace high under the axilla with a pad and an elastic gusset on the opposing
side. As you know, many adolescent females simply will not wear a brace that
might show too much through their clothes, no matter how well it might hold
them.
None, to the best of my knowledge.
Our customers have had very good results treating curves with an apex
above T8 with the LOC Scoliosis brace. You can view the trimline
styles and some product information at our website.
www.spinalbraces.com
John, The Providence uses a special measurement board rather than a cast and
can be purchased from Spinal Tech (you might have to take the Providence
course in order to use the brace). But the concept could be copied. Spinal
Tech has some info about the brace at: www.SpinalTech.com
< <URL Redacted>> You can call for information directly to
Providence at: 800-253-7868. Again, this is a nocturnal brace that can be
used w/ double curves w/ a high apex. Hope this helps. Any other questions,
feel free to reply.
A couple of thoughts for ya!
Have you tried nocturnal bracing on either of these kids. I've used the
Charleston brace for years, but about two years ago, I started using the
Providence Scoliosis System which is patented by Spinal Technology of West
Yarmouth, Mass. It catches both curves (if your pt. has two) and has much
higher trimlines then the Charleston. The results have been very good (75%
reduction in brace) in my own practice. My docs are happy, too!]
Also, one of my Orthos. went to a seminar put on by the Minnesota Spine
Instotute (not sure if thats the right name, but I probably can dig it up).
They make a brace called the Priest which has a low profile metal collar
that comes around the neck. I guess this is their low profile version of a
Milwaukee brace. Hope this helps.'
Regards
John.
.Dear John, The Milwaukee Brace may not ever be in vogue again and thank
God for that, but it is still a good choice for superior curves (above T 8)
for compliant (a rare breed)! patients.
John-
What is the apex of the curve? I've done a lot of scoly work the last few
years, and in that time, I've only done one Milwaukee brace. Keep in mind
that T8 is a textbook value for the exam. I have successfully braced kids at
T6 or T7 with a Boston style TLSO.
I my continuing experience, they are very much in vogue in the States and
abroad, with minor variations. There is some evidence that thoracic
curves don't correct well with any brace, but the Milwaukee and its
variants are the only brace available if bracing is the route being
travelled. The Milwaukee Brace by Blount and Moe might still be the
definitive book on the subject, though written some 30 years ago,
covering fabrication and theory. The priniciples haven't changed much.
John,sorry to hear that you had such little response. Although I am
currently out of clinical practice, the treatment of scoliosis was always a
big part of my practice and has always held special interest for me. I am
not aware of any courses currently being offered on the Milwaukee brace,but
I beleive it is still the gold standard for treating curves above T-8. The
best book on the Milwaukee brace is still Blount's book entitled The
Milwaukee Brace. I do not know where to find it these days but maybe
someone elseWe use the boston type orthosis with the idea that with better
compliance if
we get the lower curves supported the top curves will be more stable. Who
even knows if scoli bracing works long term at all or enought to put the
kids through it.
Dear John, I'm using for curves on the coronal or sagital plane a CTLSO,
could be with the regular neck ring ( Milwaukee Brace) or Low profile neck
ring.
To me the CTLSO is the most appropiate brace to traet curves above T8.
I'm sorry I didn't read your first E. Mail. What do you want to know about
Milwaukee Brace?, Maybe I can share my ideas and Experince.
At Connecticut Children's Medical Center, we are using the Boston Brace for
curves w/ an apex as high as T 7. We use a nocturnal brace called the
Providence for double curves w/ an apex as high as T 6. We do still use
Milwaukee's- some with a low profile neck ring as opposed to the
superstructure. To complete the picture of Idiopathic Scoli bracing at our
facility, we generally use the Charleston for single Thoracic and single
Thoracolumbar apical curves. Hope this helps.
For treating patients with Apices of T8 or above, we do a modified Milwaukee
type brace, with a neck rings rather than the very high superstructure. The
main problem here is compliance. The large superstructure is CLEARLY
visible
through the clothes and compliance is very low - especially the older the
child you are trying to treat.
The neck ring is much lower in profile and provides some of the leverage
principles inherent to the Milwaukee. As far as the success between one and
the other - I believe that at least with the neck ring, there is SOME chance
the patient will be wearing it and benefitting from it. When it comes to
the
Milwaukee, I don't know what to believe.
If you wish to see what I'm talking about, the low profile neck ring is
available through Fillauer. If you need any more information, I'd be happy
to help you in any way I can.
Take care and good luck
This is very true. In cases of paralytic or neuromuscular imbalance
realted scoliosis, the Milwaukee requires active pulling away form the
corrective pad and is not at all recommended. We use a total contact
TLSO, either hard shell with cutouts or soft circumferential in these
cases.
We have noticed a significant decrease in bracing in just the last 5
years. Seems the physicians are interviening surgically much earlier
than before. The Milwaukee is still the orthosis of choice if the curve
is above T8. Or adding a Milwaukee type super structure to a Boston
type jacket.
Good Luck,
As far as I know, only the Milwaukee. I don't need to use very often. So
far, I have been able to use the low profile neck ring on the ones I have
done, which makes it more livable. You can get the low profile neck ring
from Fillauer.
BOSTON OVERLAP OR NIGHT BENDING TLSO
Houston still uses quite a few Milwaukee CTLSOs for curves with apices
superior to T-8.
Probably many folks on the OANDP-L never saw a Milwaukee brace for scoli
treatment. In the U.S. Air Force, we stopped using Milwaukees about 20+
years
ago, in favor of the Boston Brace (with neck ring and superstructure if
needed
for high curves) I don't see a web site on a note pad I have from them, but
the
address is:
Boston Brace International, Inc.
20 Ledin Drive
Avon, MA 02322
FAX: 508 587-8119
(800) 262-2235
FWIW, I have had limited success with curves above T8 by leaving the Boston
Brace high under the axilla with a pad and an elastic gusset on the opposing
side. As you know, many adolescent females simply will not wear a brace that
might show too much through their clothes, no matter how well it might hold
them.
None, to the best of my knowledge.
Our customers have had very good results treating curves with an apex
above T8 with the LOC Scoliosis brace. You can view the trimline
styles and some product information at our website.
www.spinalbraces.com
John, The Providence uses a special measurement board rather than a cast and
can be purchased from Spinal Tech (you might have to take the Providence
course in order to use the brace). But the concept could be copied. Spinal
Tech has some info about the brace at: www.SpinalTech.com
< <URL Redacted>> You can call for information directly to
Providence at: 800-253-7868. Again, this is a nocturnal brace that can be
used w/ double curves w/ a high apex. Hope this helps. Any other questions,
feel free to reply.
A couple of thoughts for ya!
Have you tried nocturnal bracing on either of these kids. I've used the
Charleston brace for years, but about two years ago, I started using the
Providence Scoliosis System which is patented by Spinal Technology of West
Yarmouth, Mass. It catches both curves (if your pt. has two) and has much
higher trimlines then the Charleston. The results have been very good (75%
reduction in brace) in my own practice. My docs are happy, too!]
Also, one of my Orthos. went to a seminar put on by the Minnesota Spine
Instotute (not sure if thats the right name, but I probably can dig it up).
They make a brace called the Priest which has a low profile metal collar
that comes around the neck. I guess this is their low profile version of a
Milwaukee brace. Hope this helps.'
Citation
Polglase, John K, “Milwaukee brace responses.,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 8, 2024, https://library.drfop.org/items/show/216368.
