Comparison of efficacy, tolerance, and professionals' opinions between plaster casting and 3D scanning in manufacturing the Garches brace.

Abstract

Neuromuscular diseases cause hypotonia and axial weakness, leading to a high incidence of severe, progressive scoliosis usually initially treated by bracing. The Garches brace is the most widely used brace in France for children with severe congenital neuromuscular disease. We compared 2 methods for Garches brace manufacturing, 3D scan acquisition, and plaster casting, in efficacy, acceptability, and tolerance. We conducted a retrospective, noninterventional single-center study on 101 braces made between January 2013 and October 2023 for 32 children. Changes in Cobb angle with the brace, manufacturing delay, number of fittings, skin tolerance, daily wearing time, and time until brace replacement between plaster casting and 3D scan acquisition were tested. Semi-structured interviews collected professionals' opinions of the methods. Change in Cobb angle did not differ between the methods (p = 0.169). Manufacturing delay was similar (p = 0.657), as was the number of fittings (p = 0.744) and number of skin disorders (p = 0.596). Interviews with professionals highlighted the necessity to move on from plaster casting methods and emphasized the comfort provided to children and the improved work conditions brought by 3D scan acquisition. Improved child comfort, combined with no significant difference in tolerance, lifespan, and effectiveness to plaster casting, supports the adoption of 3D scan acquisition for Garches brace manufacturing.