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Background: Transient femoral nerve palsy is a potential complication of the use of a Pavlik harness to treat developmental dysplasia of the hip. Our hypothesis was that patients who develop a femoral nerve palsy while undergoing Pavlik harness treatment for developmental dysplasia of the hip are more likely to have unsuccessful orthotic treatment and to require closed or open hip reduction. Methods: We performed a retrospective review of all patients who underwent PavIlk harness treatment for developmental dysplasia of the hip within a seventeen-year period (1992 to 2008). All cases of femoral nerve palsy were identified and reviewed. Thirty infants met the study criteria and formed the palsy group. A control group of seventy-nine infants who did not develop femoral nerve palsy during treatment was randomly selected. Results: Thirty cases of femoral nerve palsy were identified from a group of 1218 patients for an incidence of 2.5%. Eighty-seven percent of femoral nerve palsies presented within one week of application of the Pavlik harness. Femoral nerve palsy was more likely in older, larger patients in whom the developmental dysplasia of the hip was of higher severity. Patients whose femoral nerve palsy resolved within three days had a 70% chance of having successful treatment with the Pavlik harness, whereas those who had not recovered by ten days had a 70% chance of having treatment failure with the Pavlik harness. The success rate associated with treatment with a Pavlik harness was 94% in our control group and 47% in our palsy group. Conclusions: Femoral nerve palsy is an uncommon yet clinically important complication of Pavlik harness treatment for developmental dysplasia of the hip. This complication is strongly predictive of failure of treatment, and its impact is greatest when the developmental dysplasia of the hip is higher in severity. Early recognition and management of femoral nerve palsies may improve the success of treatment. Level of Evidence: Therapeutic Level III. See Instructions to Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]

The article presents a case study of an eighty-seven-year-old woman who fell from standing height and landed on her right arm. A varus deformity of the right humerus was shown and radial nerve function was not damaged on examination in the emergency department. A nonoperative course of treatment was selected, as the patient had several underlying comorbidities. A functional brace was added to treat the fracture, but complications occurred.

The balance function of children is known to be affected by carriage of a school backpack. Children with adolescent idiopathic scoliosis (AIS) tend to show poorer balance performance, and are typically treated by bracing, which further affects balance. The objective of this study is to examine the combined effects of school backpack carriage and bracing on girls with AIS. A force platform was used to record center of pressure (COP) motion in 20 schoolgirls undergoing thoraco-lumbar-sacral orthosis (TLSO brace) treatment for AIS. COP data were recorded with and without brace while carrying a backpack loaded at 0, 7.5, 10, 12.5 and 15% of the participant’s bodyweight (BW). Ten participants stood on a solid base and ten stood on a foam base, while all participants kept their eyes closed throughout. Sway parameters were analyzed by repeated measures ANOVA. No effect of bracing was found for the participants standing on the solid base, but wearing the brace significantly increased the sway area, displacement and medio-lateral amplitude in the participants standing on the foam base. The medio-lateral sway amplitude of participants standing on the solid base significantly increased with backpack load, whereas significant increases in antero-posterior sway amplitude, sway path length, sway area per second and short term diffusion coefficient were found in participants standing on the foam base. The poorer balance performance exhibited by participants with AIS when visual and somatosensory input is challenged appears to be exacerbated by wearing a TLSO brace, but no interactive effect between bracing and backpack loading was found. [ABSTRACT FROM AUTHOR]

Context: Although prophylactic ankle bracing has been shown to be effective in reducing the incidence of ankle sprains, how these ankle braces might affect the other joints of the lower extremity is not clearly understood. Objective: To determine the effects of a prophylactic ankle brace on knee joint varus-valgus and internal-external rotation torque during a drop landing onto a slanted surface. Design: A repeated-measures design. Setting: Biomechanics research laboratory. Patients or Other Participants: Twenty-four physically active college students. Intervention(s): Participants were tested in a brace and no brace condition. Main Outcome Measure(s): We measured 3 dependent variables: (1) peak ankle inversion-eversion torque, (2) peak knee varus-valgus torque, and (3) peak knee internal-external rotation torque. A forceplate was used to collect ground reaction force data, and 6 motion analysis cameras collected kinematic data during the unilateral drop landing. An adjustable bar was hung from the ceiling, and a slant board was positioned over the center of the forceplate, so that the ankle of the participant's dominant leg would invert upon landing. Peak torque was measured in both the brace and no-brace conditions. The average of the peak values in 3 trials for both conditions was used for the statistical analysis. Results: Ankle eversion torque was significantly greater in the brace condition (F == 19.75, P < .01). Knee external rotation torque was significantly greater in the brace condition (F == 4.33, P < .05). Valgus knee torque was smaller in the brace condition, but the difference was not statistically significant (F = 3.45, P < .08). Conclusions: This study provides an important first step in understanding the effects of prophylactic ankle bracing on other joints of the lower extremity. We found that prophylactic ankle bracing did have an effect on knee torque when the subject was landing on a slanted surface. Specifically, knee external rotation torque increased when the ankle was braced. [ABSTRACT FROM AUTHOR]

Examines the case of a woman with contact allergy to IPPD and diphenylthiourea in an orthopedic brace. Occurrence of heavy perspiration; Development of severe painful erythematous vesicular eruption; Treatment with potent topical corticosteroid.