Brace application

Putting the brace on properly is important so it will be comfortable and do its job. In almost all cases, your child will need help putting it on.

• As you and your child are standing, put the brace around your child and tighten the neck ring.
• Hold the front metal upright with both hands and lift the brace toward your child's head.
  As you do this, tighten the strap on the pelvic piece as snuggly as possible; be careful not to twist the pelvic piece around your child's midsection.
• Finally, fasten the pads as marked.

When the brace is applied properly, there should be no pressure from the chin piece as your child stands and sits. Warn your child to avoid resting his / her chin on the throat mold. The back of your child's head should rest on the occipital piece, and this should fit comfortably. If the pelvic piece is not fastened tightly enough, it will ride down over your child's pelvic bones and cause soreness and skin irritation.

The doctor will want to see your child frequently when he / she first starts wearing the brace because adjustments will be necessary. If there is a space greater than one inch between the chin and thoracic mold, the brace may need a lengthening adjustment.

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Milwaukee Brace care

The Milwaukee brace is difficult to make and is constructed especially to fit your child. It should be treated carefully. If any screws become loose, they should be tightened. Under no circumstances should you lengthen or shorten the brace without definite instructions from your child's doctor.

The metal uprights and screws tend to cause excessive wear and tear on clothes. Using 3M– Strapping Tape – placed lengthwise along the uprights – helps this. If the surfaces of the pads, chin piece or head rest become dirty or stained, use soap and water to clean them. If problems occur, immediately call your child's orthotist for adjustment. Do not wait for your child's next office visit.

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Cervico-Thoraco-Lumbo-Sacral-Orthosis

The Milwaukee Brace is commonly used for high thoracic (mid-back) curves. It extends from the neck to the pelvis and consists of a specially contoured plastic pelvic girdle and a neck ring connected by metal bars in the front and the back of the brace. The metal bars help extend the length of the torso and the neck ring keeps the head centered over the pelvis. Pressure pads, strategically placed according to the patient's curve pattern, are attached to the metal bars with straps.

The Milwaukee Brace was the first modern brace designed for the treatment of scoliosis. Developed by Drs. Walter Blount and Albert Schmidt of the Medical College of Wisconsin and Milwaukee's Children's Hospital in 1945, its design has been tweaked through the years until reaching its current design around 1975.

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The Milwaukee brace

The Milwaukee brace, also known as a cervico-thoraco-lumbo-sacral orthosis or CTLSO, is a back brace used in the treatment of spinal curvatures (such as scoliosis or kyphosis) in children. It is a full-torso brace that extends from the pelvis to the base of the skull. It was originally designed by Blount and Schmidt in 1946 for postoperative care when surgery required long periods of immobilization.

Milwaukee braces are often custom-made over a mold of the patient's torso, but in some cases, it can be made from prefabricated parts. Three bars—two posterior and one anterior—are attached to a pelvic girdle made of leather or plastic, as well as a neck ring. The ring has an anterior throat mold and two posterior occipital pads, which fit behind the patient's head. Lateral pads are strapped to the bars; adjustment of these straps holds the spine in alignment.

This brace is normally used with growing adolescents to hold a 25° to 40° advancing curve. The brace is intended to minimize the progression to an acceptable level, not to correct the curvature. For corrective measures, special exercises or physical activities are used. If the curvature continues despite the brace, surgery may be required.

The Milwaukee brace is often prescribed to be worn 23 hours a day for several years.

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