Children and young people in orthopedics – growing bodies, special considerations

Manufacturing aids for children and young people makes different demands than working with adult users. An adult body's measurements change slowly, but a child or teenager grows and develops continuously, and the aid that fit half a year ago may be too small or sit wrong today.

Because the body grows, aids for children and young people require far more frequent checks and adjustments than corresponding aids for adults. The orthopedist must plan closer follow-up from the start and be prepared for an aid to be adjusted or renewed several times during a treatment period as the user grows.

Scoliosis, a side curvature of the spine, is often discovered and worsens during puberty, when growth is fastest. Here the back brace is used to slow development while the patient is still growing, typically as a 24-hour brace worn around 23 hours a day. When the brace is first issued, the young person is often admitted briefly for acclimation, where putting on and taking off is practiced and wear time is gradually increased.

• 01Body image: a visible aid can affect how a teenager feels among peers
• 02School and sports: the aid must function in everyday activities, not just at rest
• 03Parental involvement: parents must understand the purpose use and follow-up
• 04Motivation: a young user must understand and want to use the aid themselves for treatment to work

The orthotist must often explain the same issue at two levels simultaneously: the child or young person must understand what the aid does and why it is worth the discomfort to wear, while the parent must understand the slightly more technical background and be able to support its use at home. The double communication is an important but often overlooked part of the profession.

“An aid for a child must not just fit today — it must be able to grow with the child.”

— Pedagogical basic rule