Clamshell Brace

What is a clamshell brace?

• A clamshell brace is a device that keeps your spine from moving. Your spine is a column of bones that runs down your back. A clamshell brace wraps around your back, chest, and stomach area and holds your spine in place. This can help ease pain, protect your spine from injury, and allow an injury to heal. A clamshell brace prevents you from bending forward or backward. It also keeps you from twisting side-to-side. A clamshell brace is also called a thoracolumbarsacral orthosis (TLSO).
  
  
• A clamshell brace is made of plastic and fits the shape of your body. Caregivers may make a mold of your body and use it to make a brace that fits your body exactly. They may also measure your body and adjust a pre-made brace to fit your body correctly. A two-piece clamshell brace consists of a piece of plastic that covers your front and another piece that covers your back. These pieces are held together on the sides by fabric straps that stick together. A one-piece clamshell brace consists of one piece of plastic that covers your front and back. This piece is closed in the front using fabric straps that stick together.

Why might I need a clamshell brace?

You may need a clamshell brace if you have a fracture (break) in the bones of your spine. You also may need one if you have damage to your spinal cord. This is a cord of tissue within the spine. It contains many nerves and controls your ability to move.

What do I need to know about my clamshell brace?

Always wear the brace according to your caregiver’s instructions. He will tell you how often and how long you need to wear the brace. Do not bend while wearing the brace. Also, do not try to lift anything that weighs more than 10 pounds. Always have someone help you when putting on or taking off your brace. Some clamshell braces may extend to the upper thigh to provide more support to your lower spine. Ask your caregiver for more information about this thigh extension.

How do I use a two-piece clamshell brace?

• To put on a two-piece clamshell brace:
  
  
  • Lie flat on your bed and log roll onto your side. To log roll, turn your whole body in a straight line with your back flat and straight.
    
    
  • Have another person place the back half of the brace onto your back. Log roll back into the brace.
    
    
  • Check to see that the indented spots on the right and left sides of the brace are placed between your lowest rib and your hip bone. The indented spots should line up with your belly button. If the brace is not centered correctly, roll to your other side and adjust the brace. You may also move the brace up or down to adjust it.
    
    
  • Lie flat on the back half of the brace with your knees bent and your feet flat on the bed. Place the front half of the brace on top of your chest and abdomen (stomach area). The sides of the top half should overlap the sides of the bottom half.
    
    
  • Pull and fasten the fabric straps on the sides of the brace. Some caregivers draw a line on the straps to show how tight they should be pulled.
    
    
  • Check to see that the brace is in place. When you sit, the front edge of the brace will touch the tops of your legs. The back edge will reach about an inch above the seat.
  
  
• To remove a two-piece clamshell brace:
  
  
  • Lie flat on the bed. Detach the fabric straps on the sides of the brace. Lift off the front half of the brace.
    
    
  • Log roll onto your side. Have your helper remove the back half of the brace.

How do I use a one-piece clamshell brace?

• To put on a one-piece clamshell brace:
  
  
  • Lie on your back with your knees bent and your feet flat on the bed.
    
    
  • Have another person slide the brace under your thighs. Raise your buttocks slightly so your helper can slide the open brace under your buttocks and your back.
    
    
  • Check to see that the indented spots on the right and left sides of the brace are placed between your lowest rib and your pelvic bone. The indented spots should line up with your belly button. If they do not, move the brace up or down to adjust it.
    
    
  • Pull and fasten the fabric straps on the front of the brace. Some caregivers draw a line on the straps to show how tight they should be pulled.
    
    
  • Check the indented spots to see that the brace is in place. When you sit, the front edge of the brace will touch the tops of your legs. The back edge will reach about an inch above the seat.
  
  

How do I care for my clamshell brace?

Clean your clamshell brace by washing all of its surfaces with a wet, soapy sponge. Rinse the soap off. You can use rubbing alcohol to remove bacteria and dried soap from the inside of the brace. Bacteria and dried soap can irritate your skin. Always make sure the brace is completely dry before putting it back on.

How do I care for my skin while using a clamshell brace?

• Always wear a clean, dry cotton shirt under your clamshell brace. This can be a T-shirt or other snug-fitting shirt. The shirt will help absorb sweat and protect your skin. Skin powder also may help reduce the amount of moisture on the skin beneath the brace. However, too much powder can build up and irritate your skin.
  
  
• Check all areas of your skin beneath the brace every day. If you find red or irritated areas, check the position of your brace to make sure it is not too tight or too loose. If you have a rash, try changing your T-shirt more often. This can help if the rash is caused by heat, sweat, or laundry products.
  
  
• Talk to your caregiver about showering. You may be able to take off the brace to shower. You also may be able to shower while wearing your brace. If you shower with the brace on, be sure to thoroughly dry the brace and the skin under the brace.

What are the risks of using a clamshell brace?

• You may have pain while caregivers measure you for the brace or while they create a mold. You may have to wait while the brace is being made. If your body changes in size or shape after you get the brace, the brace may no longer fit. This may occur if swelling from an injury goes down or if you gain or lose weight.
  
  
• You may have trouble with simple daily activities while wearing the brace. These include sitting up, standing up, and lifting. You may not be able to breathe as deeply. You may feel full sooner when eating. The brace may press on your skin and cause pain, irritation, sores, and ingrown hairs. You may get hot or sweat while wearing the brace. Sweat may lead to skin irritation.
  
  
• Muscles near your spine and abdomen may weaken because they are not being used. After an injury, it may take longer for you to return to your normal daily activities because of these weak muscles. If the brace is not applied correctly, your spine may not be held in place. Talk to your caregiver if you have questions or concerns about your condition.

When should I call my caregiver?

Call your caregiver if:

• Your skin is sore, red, or irritated because your brace rubs against it.
  
  
• Your arms, hands, or legs are numb or tingling.
  
  
• Your body changes in size or shape, and your brace feels loose or tight.
  
  
• You had surgery and your incision (cut) is leaking fluid.
  
  
• You have increasing pain even while wearing the brace.
  
  
• You have new or worsening weakness in your arms or legs.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Copyright © 2012. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.