Original ArticleManagement of deformational plagiocephaly: Repositioning versus orthotic therapy
Section snippets
Methods
Longitudinal data were collected on 298 consecutive normal infants, who were referred and treated for plagiocephaly at Cedars-Sinai Medical Center between January 1, 1994, and December 31, 2001. Cranial diagonal differences (DD) were compared before and after treatment. Institutional Review Board review was obtained to use anonymized patient care data. We compared size at birth and at the last treatment visit between the two sexes. Cranial diagonal measurements were taken by anthropometric
Results
The mean age of 298 infants treated for plagiocephaly was 5.4 months; the mean length of treatment was 4.3 months; 70% were boys; 68% were left-sided. Size differences between boys and girls were not significant (Table I). Among 176 infants treated with repositioning, the mean RDD was 0.55 cm (±0.33), from a starting mean DD of 1.05 cm at 4.8 months. In 159 infants treated with helmets, the mean RDD was 0.71 cm (±0.36), from a mean starting DD of 1.13 cm at 6.6 months. The final DD for
Discussion
Before 1992, anterior deformational plagiocephaly predominated when infants slept on their stomachs.14 Among supine-sleeping infants with torticollis, one side of their occiput (more commonly the right side) becomes flattened, resulting in posterior deformational plagiocephaly. The incidence of torticollis was 1.3% among 250,000 Hong Kong infants followed in a prospective study of 1086 patients with congenital muscular torticollis seen in one center over a 12-year period.8 Torticollis was more
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Supported by SHARE's Childhood Disability Center, the Steven Spielberg Pediatric Research Center, the Cedars-Sinai Burns and Allen Research Institute, the Skeletal Dysplasias NIH/NICHD Program Project Grant (HD22657-11), and the Medical Genetics NIH/NIGMS Training Program Grant (GM08243).