Requirements for modern scoliosis orthoses and treatment teams
Personal responsibility of scoliosis patients and families
It is especially important for the scoliosis patient to understand exactly how the scoliosis corset works. In this way, he or she can continuously check independently, for example with daily personal hygiene, whether the corset is still seated correctly. The more experience is gained in dealing with it, the sooner it can be ensured that there is no uncertainty caused by ignorance when changing therapists or doctors.
It is difficult for scoliosis practitioners who have little experience with Chêneau trunk orthoses to assess the fit. In view of this, there is always confusion and uncertainty in scoliosis patients and their relatives in certain situations.
In particular, the corset check-up appointments and routine examinations during scoliosis treatment are of particular importance throughout the course of treatment. The regular check-up dates specified by the orthopedic technician should always be adhered to. They serve to ensure that the fit and function of the scoliosis orthosis is still ensured.
(Figure: Scoliosis patient in the first corset – there is enough room for breast development of impending growth.) The thoracic lateral artery area – the lateral thoracic aorta – is proper.)
Structure, effect and use in the chest area
Scoliosis corsets, which are state-of-the-art in orthopedic and medical terms, contain, in view of their structure, abutment zones and free spaces in order to achieve a three-dimensional correction. In order to achieve this, most scoliosis types require that the breast lying in the concave side of the curve be raised and the underlying ribs derailed against the curve.
(Figure: Cheneau’s corset with enough expansion space and proper adjustment of the chest zones.) The lateral thoracic aureole is safe even with more breast tissue.)
To implement this correction, the chest is lifted off the corset together with the armpit area. At first glance, this mechanism seems to take some getting used to for the inexperienced eye. However, it is easy to check whether the corset is endangering breast growth. In the lower area of the raised breast side, no corset edge may press or cut. In this zone are the mammary glands. The corset must be arched in this area in order to lift the breast tissue without causing edge pressure on the underlying mammary glands.
An important point is that the scoliosis corset allows the blood supply to the chest without restriction. The artery is one of the most important blood vessels for the supply of breast tissue.
The lateral support under the raised armpit area must be worked in such a way that no blood vessels are affected. Particularly in the area of the lateral thoracic artery (arteria thoracica lateralis) great care and attention on the part of the attending orthopedic technician is required. A pronounced correction of the breast is required for certain bends. The chest is also securely bedded on both sides of the scoliosis orthosis.
For all professional groups caring for scoliosis, it should be clear how a modern trunk orthosis is constructed and works technically. This is the only way for the scoliosis practitioner to assess whether the orthosis is still fit or may need to be reworked.
Minimize the risk of breast deformity
(Illustration; scoliosis patient with Ortholutions Original RSC® (Rigo System Cheneau®) brace. The chest area fits on both sides.)
As the scoliosis expert Dr. Hans Rudolf Weiss in his Scoliosis Guide “Ich habe Skoliose – Ratgeber für Betroffene, Angehörige und Therapeuten” (German language edition; title tranlation: “I have scoliosis – guide for sufferers, relatives and therapists“), breast deformities in scoliosis patients and scoliosis patients by a well-adapted scoliosis corset are very rare. In order to avoid unnecessary changes and risks in the course of treatment, certain requirements for the scoliosis orthosis and the treatment team are of great importance. In addition, scoliosis patients and their families also bear part of the responsibility for successful scoliosis treatment.
Responsibility for everyone during scoliosis treatment
For the treating professionals – orthopedic technicians, physiotherapists and physicians – it is necessary that they have knowledge of the fit and function of a trunk orthosis, which are required in the context of modern scoliosis treatment.
The families of the affected scoliosis patients have individual responsibility. This starts with the selection of experts. It is also important for them to support the sick child in wearing the scoliosis orthosis and, if necessary, to check the fit together.
Regular routine corset check-up should always be followed during scoliosis treatment. Because even a scoliosis corset that initially functions well can lead to avoidable deformity of the breast due to growth.