Technical Note: Modification Of Outrigger On Milwaukee Orthosis
Marshall Kaufman, B.M.E.
Isadore Zamosky, C.P.O.
Sometimes, when fitting the Milwaukee orthosis on female patients, the level of the thoracic pad is such that the front outrigger is at the level of the fullness of the breast, and, with proper clearance, passes directly over it (Fig. 1 ).
This placement imposes an unnecessary cosmetic and thus psychological burden on the typical adolescent female patient, because the softness and contour of one breast is obscured by the protrusion of the overlying hard metal.
This problem can be eliminated easily by substituting a simple L-bracket for the horizontal outrigger (Fig. 2 ). The L-bracket is fastened to the front upright at a level just below the bottom of the breast. The horizontal leg is contoured to the front of the chest wall just below the breast (allowing clearance for chest expansion), and is extended laterally beyond the lateral fullness of the breast. From this point, the vertical leg begins, and rises to the level at which the strap for the thoracic pad must be fastened.
The two breasts now present equal, normal fullness and softness—an aid in fulfilling the cosmetic and psychological requirements of the wearer.
This method of substituting an L-bracket for the usual front outrigger to anchor the strap for the thoracic pad has been used on 12 patients, and has proved to be successful biomechanically and psychologically in each case.