malposition

Observation

Curves < 20^o observation only at 3-6 month intervals depending on growth rate 

Non Operative Management / Bracing 

Never brace curves if patient Risser 4 or 5 

Indications

1.  Risser 0-2 (growth potential)

2.  Curve >30^o adolescent

3.  Curve >25^o with progression (5^o in six months)

Bristow

Concept

Non-anatomical bony block 

- transfer of coracoid process through subscapularis

- dynamic anteroinferior musculotendinous sling

- provides subscapularis tenodesis

- preventing lower portion from displacing proximally as arm abducted

- when shoulder in vulnerable position abduction and ER