traction

[cecilia]

Hi,

I am a PA and have a question for the orthopedic docs. What do you think about traction for a teenager with 1-mild scoliosis, and 2-moderate scoliosis. Thank you.

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[DPTATC]

Hi,

I am a PA and have a question for the orthopedic docs. What do you think about traction for a teenager with 1-mild scoliosis, and 2-moderate scoliosis. Thank you.

I am not an Ortho doc but am a PT ATC. Often mild scoliosis in a growing teenager is really because of a leg length discrepancy. The proper treatment is a lift in the short leg's shoe and self mobilization of the pelvis iinferiorly. Have them do this until they stop growing then reassess the leg length. a good way to measure this precisely is to do a standing AP pelvis Xray with both feet in subtalar neutral and both knees fully extended. You measure on the film from the ASIS to the bottom and get the exact asymmetry. Once they stop growing, you can recommend a permanent lift in the shoe

 

[volkl7]

I am not an Ortho doc but am a PT ATC. Often mild scoliosis in a growing teenager is really because of a leg length discrepancy. The proper treatment is a lift in the short leg's shoe and self mobilization of the pelvis iinferiorly. Have them do this until they stop growing then reassess the leg length. a good way to measure this precisely is to do a standing AP pelvis Xray with both feet in subtalar neutral and both knees fully extended. You measure on the film from the ASIS to the bottom and get the exact asymmetry. Once they stop growing, you can recommend a permanent lift in the shoe

holy ****, DPTATC doesn't know what the hell he/she is talking about. i truly hope he/she doesn't lay hands on children or any patients.
...a shoe lift until they stop growing... perfect, that way you may miss a progressive scoliosis and a potentially treatable leg length discrepancy. btw, a scanogram may better define the true leg length discrepancy.
..."once they stop growing, you can recommend a permanent lift"... great, that 8cm shoe lift will really be tolerated and definitely help that 90 degree curve.
DPTATC, please send your kid to a professional.

 

[DPTATC]

holy ****, DPTATC doesn't know what the hell he/she is talking about. i truly hope he/she doesn't lay hands on children or any patients.
...a shoe lift until they stop growing... perfect, that way you may miss a progressive scoliosis and a potentially treatable leg length discrepancy. btw, a scanogram may better define the true leg length discrepancy.
..."once they stop growing, you can recommend a permanent lift"... great, that 8cm shoe lift will really be tolerated and definitely help that 90 degree curve.
DPTATC, please send your kid to a professional.

relax, you evidently didn't read the word "mild" in the original post or at the beginning of my response. I think 90 degrees would not qualify as "mild or moderate:.

 

[volkl7]

relax, you evidently didn't read the word "mild" in the original post or at the beginning of my response. I think 90 degrees would not qualify as "mild or moderate:.

dude, the point is that the initial "mild" curve can progress to 90 degrees if it is treated with a shoe lift and if it is not monitored serially, especially if the child is skeletally immature (ie risser 0 or 1, premenarchal).

btw, traction will not correct/straighten out a curve, nor will bracing, exercises, electrical stimulation, etc. a brace will only help with preventing the progression and 1/3 of those who were braced still require surgical intervention.

 

[truthseeker]

dude, the point is that the initial "mild" curve can progress to 90 degrees if it is treated with a shoe lift and if it is not monitored serially, especially if the child is skeletally immature (ie risser 0 or 1, premenarchal).

btw, traction will not correct/straighten out a curve, nor will bracing, exercises, electrical stimulation, etc. a brace will only help with preventing the progression and 1/3 of those who were braced still require surgical intervention.

I think what he meant by a lift is to put it in the side of the Lumbar convexity. In my experience, when monitored, this is very helpful with symptom management. Again, this is only with mild scoliosis, the kind found in a screening by the school nurse. Usually it is not treated at all, and usually goes away when their legs grow. If they end up with equal length there is no problem, often they don't and unilateral symptoms occur in the SI, knee, PF joint, plantarfascia, trochanteric bursa etc . . . because of the leg length discrepancy.