The chêneau concept of bracing--actual standards.

In-brace correction and compliance are the main predictors of a successful outcome of brace treatment in the management of patients with Idiopathic scoliosis. The latest CAD/CAM or module based bracing concepts, related to a proper classification have lead to a better in-brace correction and have made the braces easier to wear for the patient. Nevertheless, the latest developments on the market do not allow successful treatment in every case. The latest biomechanical models of brace correction therefore may lead to a differential indication for certain concepts described in this paper. Thoracic curves with Cobb angles < 50 degrees may be treated with the best possible success with the latest Chêneau derivates enabling a real 3D-correction including also the sagittal correction of the spine. The application of those braces demands a proper classification of curve patterns. Thoracic curves with Cobb angles > 50 degrees demand to increase the force vector from dorsal with the ventral counteraction of subclavicular pads both sides, although this may be at the cost of sagittal correction. The percentage of in-brace correction is a good indicator for brace action, however in the individual case this is not always the most important factor.