| Milwaukee brace (cervical-thoracic-lumbo-sacral orthosis) | 970.000000000000 | Milwaukee brace (cervical-thoracic-lumbo-sacral orthosis) | Milwaukee brace (cervical-thoracic-lumbo-sacral orthosis) | M | English | Orthopaedics/Musculoskeletal | Pre-teen (9-12 years);Teen (13-18 years) | Spine | Skeletal system | Non-drug treatment | Caregivers
Adult (19+) | NA | | 2021-08-09T04:00:00Z | | | | | | 7.00000000000000 | 72.7000000000000 | 1189.00000000000 | | Health (A-Z) - Procedure | Health A-Z | <p>Learn how to wear and take care of a Milwaukee brace (cervical-thoracic-lumbo-sacral orthosis [CTLSO]).</p> | <figure>
<span class="asset-image-title">Milwaukee brace</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/Milwaukee_brace_EQUIP_ILL_EN.jpg" alt="Illustration of Milwaukee body brace" />
<figcaption class="asset-image-caption">The Milwaukee brace is custom fit to each patient. Often the patient has a choice of colours and patterns for the surface of the brace.</figcaption></figure>
<h2>What is a Milwaukee brace?</h2><p>A Milwaukee brace is a body brace worn to minimize the risk of progression of scoliosis and kyphosis. It is also known as a cervical-thoracic-lumbo-sacral orthosis (CTLSO). It is worn over an undershirt to protect the skin.</p> | | <h2>Key points</h2><ul><li>A CTLSO is prescribed when a child has a curve very high in their back, near their neck.</li><li>It will take about three weeks for your child to build up to wearing the CTLSO full time (20 to 22 hours per day).</li><li>This guide offers a suggested schedule to build up to the 20 to 22 hours slowly.</li><li>If your child is having problems with their CTLSO or you have any questions, contact your child’s orthotist.</li></ul> | | | | | | | | <h2>What to wear with a Milwaukee brace</h2><p>Loose-fitting clothes will not reveal the outline of a Milwaukee brace. It is not unusual for your child to need to wear pants that are at least one size larger in order to accommodate the brace. Pants with elastic waistbands or drawstrings may fit more easily.</p><h2>Physical activity</h2><p>Brace wear tends to make muscles weaker, especially in the stomach and lower back area, so it is extremely important for your child to be as physically active as possible. They should participate in as many sports as they can.</p><p>Some sports such as baseball and bicycling may be done with the brace on. Other activities that need a lot of flexibility, like ballet, trampoline and gymnastics, may be more difficult to do with the brace.</p><p>Activities that require your child to correct their balance quickly or need increased flexibility or bigger breaths must be done with the brace off. These include:</p><ul><li>skating</li><li>snowboarding</li><li>downhill skiing</li><li>horseback riding</li></ul><p>When the brace is removed for sports, it is considered hours out of the brace. If your child spends more than two hours out of the brace, have them continue with their daily wear schedule as closely as possible.</p><p>Generally, your child may swim without their brace since the water will support their back. Check with your child’s doctor for specific instructions about swimming and other activities.</p> | | | | | | | | | | | | <h2>Goal and requirements</h2><ul><li>Goal: To have your child wear the Milwaukee brace for 20 to 22 hours per day by the end of three weeks.</li></ul><p>This means that your child needs to:</p><ul><li>put on their brace properly</li><li>start wearing their brace gradually</li><li>look after their skin</li><li>clean their brace every day</li></ul><p>For general information about spinal braces for scoliosis, please see <a href="https://www.aboutkidshealth.ca/Article?contentid=974&language=English">Scoliosis: Treatment with a spinal brace (spinal orthosis)</a>. For more information on how your child can care for their brace, see <a href="https://www.aboutkidshealth.ca/Article?contentid=3973&language=English">Scoliosis: Caring for a spinal brace (orthosis)</a>.</p> | <h2>Putting the Milwaukee brace on</h2><p>The following steps can be performed by either you or your child once they are comfortable doing so:</p><ol><li>To put the brace on, spread the brace at the bottom of the back opening. Insert your child’s arms through the brace on either side of the front upright. Slide the opening over one hip. Reach around the front and pull the rest of the brace around your child. Make sure their neck is inside the neck ring that attaches the front upright to the back uprights.</li><li>Make sure all the straps and correction pads are outside the plastic girdle.</li><li>Make sure the brace is facing straight ahead and is not twisted. The opening of the brace should be in the middle of your child’s back. The opening of the brace at the back should be centered on the crease between the buttocks. The waist roll of the brace (the indentations inside) should sit at your child’s waist, just above the hip bones.</li><li>Initially, it may be easier to tighten the brace while your child is lying down. Their spine will be straighter. There will also be more room to tighten the brace properly. Once your child’s spine becomes accustomed to the brace, they may be able to tighten it while standing up.</li><li>Thread the closure strap through the buckle on the lower part of the brace at the back and tighten to the marked hole. Do up the closure nut behind your child’s neck at the top of the brace. As you do up the brace, you should be checking the positioning to ensure that the waist rolls are properly positioned.</li><li>Pull the extra cloth of the undershirt down around the bottom and top of the brace so that it is smooth. Make sure there are no wrinkles in the undershirt. Wrinkles can cause sores on your child’s skin.</li><li>The straps of the corrective pads should then be threaded under the uprights and done up on the appropriate buckles to the correct tightness (marks). Undoing both front and back corrective pad straps is not needed when putting on or taking off the brace. Either front or back ends can be left done up and the opposite ends can be undone.</li><li>Always do the brace up in the marked holes. If your child wears their brace loosely, they will have skin problems and discomfort. A loose brace will shift around each time they move and irritate their skin and prominent bones (ribs and hip bones). If your child experiences regular stomach bloating, they may slightly loosen the brace (no more than one hole) on each strap for a short time.</li></ol> | <h2>Getting used to wearing the Milwaukee brace</h2><p>Getting comfortable using a Milwaukee brace is like getting used to new shoes. The following program is designed to help your child’s skin and muscles adjust to having the brace on. It is a gradual build-up that usually takes two to three weeks.</p><p>You and your child should read the spinal brace daily wear schedule. Your child will follow five stages of brace wear, starting with six hours, then building up to eight, then 14, then 16 and finally 20 to 22 hours per day. This is simply a guide. Your child may make their own schedule as long as it is gradual and the brace is worn full-time after three weeks.</p><p>Have your child pin the spinal brace daily wear schedule to a bulletin board and check off each day as they complete it. If they fall behind, make sure they do not skip days. Ensure they keep following the schedule as closely as possible.</p> | | | | <h2>At Sickkids</h2><h3>Cost of a Milwaukee brace</h3><p>If your child lives in Ontario and has a valid Ontario health card, 75% of your child’s spinal brace will be paid for by the Assistive Devices Program (ADP). The remaining 25% is the responsibility of the family. Many private insurance companies cover some or all of the remaining cost. If you need help paying for your child’s brace, visit our reception desk for a list of charitable organizations that may assist you. Please visit or contact
<a href="https://www.sickkids.ca/en/care-services/support-services/childrens-orthotics/">The Children's Orthotics Clinic</a> for further information on pricing.</p> | | | | | | | | | | https://assets.aboutkidshealth.ca/akhassets/Milwaukee_brace_EQUIP_ILL_EN.jpg | Milwaukee brace (cervical-thoracic-lumbo-sacral orthosis) | | False | | | | | | | | |
