Milwaukee Brace Indications Fitting Parameters

Curve Pattern Double Thoracic Curve

Positive T1 Tilt Elevated Shoulder Rotational Prominence

Apex T6-7 Raised shoulder Decompensated

39/21

No T1 Tilt No raised shoulder No significant prominence

Curve Pattern Cervicothoracic Curve

Infantile/Juvenile Easily adjustable for growth Greater Curve Correction Open Design Compliance not an issue Sagittal alignment – hypokyphosis Ability to adjust pads Need only pelvic section replaced

Infantile Under 12 months of Age Minimal or no head control Not enough room for neck ring Progressive or large curve

Kalibus

Kalibus with head piece

Curve Size Larger Curves Excessive Decompensation

51 T11

Scheuermann’s Kyphosis Thoracic Hyperkyphosis Patient evaluation Critical Flexibility of lumbar lordosis Follow Up

T 7 78

43 64

Design Criteria Neck Ring Standard Low Profile Custom Plastic

Contour of Uprights Smallest Bars Contour as close as possible Not inhibiting breathing Not inducing thoracic lordosis Ability to set neck ring posteriorly or anteriorly

Custom Molded Modify in lumbar correction and troch extension Ability to determine lordosis Determine abdominal shape Anterior to ASIS modification Base of support Depth of waist

Choice of Plastic Plastic Neck Ring – 3/16” Copoly Kalibus – 1/8” Copoly pelvic and shoulder Ring Pelvic Section – 1/8”, 5/32”, 3/16” Copoly Custom Pads – 1/8” Surlyn or Polyethylene

Pads

CUSTOMIZE FIT

Trimlines determine angle and thickness

Curve Pattern Curve Size Age Other Etiologies SUMMARY Curve Pattern Curve Size Age Other Etiologies

It Can be Done