Objective Measurement of Brace Wear in Successfully Ponseti-Treated Clubfeet: Pattern of Decreasing Use in the First 2 Years.

Purpose: Once Ponseti correction of a clubfoot is achieved and 3-month full-time bracing treatment is completed, part-time bracing treatment for 12 hours at night for 2 to 4 years is considered necessary to maintain a successful outcome. This study objectively documents the amount of daily orthosis wear time in those who maintained correction at age 2 years and, in so doing, determines how well patients' caretakers comply with the prescribed brace program.

Methods: Patients <3 months old with idiopathic clubfeet when Ponseti treatment was initiated, who successfully maintained correction at age 2 years without surgery and who had complete objective brace wear data, were included.

The Influence of Body Habitus on Documented Brace Wear and Progression in Adolescents With Idiopathic Scoliosis.

Background: Although studies have been published stating obese patients are less compliant with brace use, no objective studies measuring hours of daily brace wear have been performed to correlate brace wear and success with body mass index (BMI). The purpose of this study was to establish the relationship between BMI and brace compliance, and between BMI and progression to surgical magnitude of 50 degrees or more.

Methods: A total of 175 adolescents were prescribed thoracolumbarsacral orthosis for the treatment of an adolescent idiopathic scoliosis and followed to completion of treatment.

Quengel Casting for the Management of Pediatric Knee Flexion Contractures: A 26-Year Single Institution Experience.

Background: Quengel casting was introduced in 1922 for nonsurgical treatment of knee flexion contractures (KFC) associated with hemophilic arthropathy. It consists of an extension-desubluxation hinge fixed to a cast allowing for gradual correction of a flexion deformity while preventing posterior tibial subluxation. The purpose of this study is to report 1 center's experience with this technique for the treatment of pediatric KFC.

The Effect of the Risser Stage on Bracing Outcome in Adolescent Idiopathic Scoliosis.

Background: To determine the influence of the Risser sign on the need for surgery in children wearing orthoses for the treatment of adolescent idiopathic scoliosis (AIS), data on compliance with brace wear were collected and analyzed.

Methods: One hundred and sixty-eight patients were prospectively enrolled at the time that brace wear had been prescribed and were followed until the cessation of bracing or the need for surgery. Inclusion criteria were a curve magnitude between 25° and 45°; a Risser stage of 0, 1, or 2; and, if female, <1 year post menarche at the time of brace prescription.

Effect of Compliance Counseling on Brace Use and Success in Patients with Adolescent Idiopathic Scoliosis.

Background: Outcomes of orthotic management of idiopathic scoliosis depend on patient compliance with brace wear. The purpose of this study was to determine if counseling based on objective compliance data increases brace wear and therefore reduces the likelihood of surgery.

Methods: Two hundred and twenty-two patients with adolescent idiopathic scoliosis were prospectively enrolled in a study to determine if physician counseling based on data obtained from compliance monitors (sensors embedded in the brace) improves brace use and decreases curve progression.