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.
Proper skin care is very important. Never use oily or greasy ointments where the brace touches your child's skin. This causes softening and results in more skin breakdown. The skin should be kept clean and dry. Apply rubbing alcohol to pressure areas to toughen skin.
If the skin around your child's pelvis becomes red or broken down, use Telfa dressing to protect the area and see the doctor as soon as possible. If the chin piece causes sweating or irritation, a smooth, light-weight covering can be made to protect this area. Most patients like to use a snug-fitting, 100 percent cotton T-shirt or stockinet under the brace. Persistent problems with your child's skin mean that the brace does not fit properly or is being worn improperly.
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. If your child's doctor recommends an adjustment, it will be done by the orthotist.
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.
Exercises and Activities
It is extremely important that your child remains active and in good physical condition.
A physical therapist will show your child a series of exercises specifically designed to treat the deformity, and to keep muscles strong. In addition to these exercises, your child should be active at home and in school. This includes gym classes, running, sports and other exercises. Horseback riding is permitted. Ask your doctor about specific activities if you have questions. Swimming is excellent exercise, and your doctor will usually allow your child to remove the brace to do this.
It is important that your child does not rest against the chin piece of the brace except for very short periods. While reading and studying, your child should either get far enough back from his / her books or use a reading stand or similar device to avoid looking down and pressing on the chin piece. Prism glasses can also be used to avoid this. While eating, your child can sit on a low stool, or raise the level of the plate.
It is usually necessary that your child wear clothing somewhat larger than normally worn. Talking with other patients and parents can provide many hints about styles and caring for clothing.
Call Your Child's Doctor If:
- Numbness, stinging or burning places occur under the brace
- A different, foul (bad) odor comes from the brace
- Pain occurs that is steady or increases, and is not relieved by medicine or a change in position
- The brace cracks
If you need to reach the orthopaedic nurse before 4 pm, Monday through Friday, call 513-636-4567. After 4 pm, and during weekends and holidays, call 513-636-4200 and ask that the orthopaedic resident on call be paged.