Ortopedická protetika Praha sro - Společnost pro pojivové tkáně

The basic strategy is obtain 3-D
correction of spine, we used CBWO
in its symetrical and asymetrical version,
Stagnara-Lyon brace, „modified“ Chêneau
brace and Milwaukee brace.
Goals of the treatment
� Before menarche and before growth
end – stop progression and correction
� Late, after menarche – stop progression
� >40 degree of Cobb angle, menarche,
high bone age: rebalancing of the
trunk, stop progression
Fig.7. „modified“ Chêneau brace
Our view on addition of Chêneau
brace
� Effective 3D correction
� Sufficient expansion spaces also by
horizontal position of the trunk
� Good guiding and capture of the pelvis
� Reliable rebalancing of the trunk
� Possibility of good guiding ribs movement
� Excellent topographic zone distinguishing
� Possibility of various activities of the
child
Results
Results depends on objetive and subjective
critera stated above.
Mobile mild curves (Cobb angle 20–
25 degrees) before menarche show very
good correction (i.e. more than 6 degrees)
during the bracing, but in general compliance
is diminished after menarche and that
participates that results are much worse. In
some cases we achieve only retention and
rarely worsening in this group.
Curves 25–35 degrees – we achieved
good correction (mobile curves), or reliable
retention (depends on natural history
of curve and compliance.)
This group rarely progress to surgery.
Curves > Cobb angle 35–40 degrees –
we achieved rarely correction and mostly
reliable retention. Some curves progress
to surgery.
Discussion
Major problem of bracing is compliance
(10, 20) in our experience it is major
reason of therapy failure. Cooperation with
family, psychologist, proper manufacturing
POHYBOVÉ ÚSTROJÍ, ročník 14, 2007, č. 3+4 251