An evidence-based stepwise approach to orthopedic treatment

Treatment protocols help organize data for accurate diagnosis and treatment planning. The aim was to develop a logical series of steps predicated on the latest credible body of evidence. The steps were developed for Class II patients with hyperdivergent growth patterns. The steps include establishing 1) the patient's problem list to determine the treatment objectives; 2) the theoretical basis modifying growth; 3) the etiology of the problem 4) the growth mechanisms that produce normal growth, and 5) a practical and realistic treatment approach. Departing from traditional assessments by reverse engineering the problem, potential gaps in the application of knowledge to practice may be recognized and addressed.