title: Management of deformational plagiocephaly: repositioning versus orthotic therapy.
abstract: OBJECTIVE
  We compare positioning with orthotic therapy in 298 consecutive infants referred for correction of head asymmetry.
  
  
  METHODS
  We evaluated 176 infants treated with repositioning, 159 treated with helmets, and 37 treated with initial repositioning followed by helmet therapy when treatment failed. We compared reductions in diagonal difference (RDD) between repositioning and cranial orthotic therapy. Helmets were routinely used for infants older than 6 months with DD >1 cm.
  
  
  RESULTS
  For infants treated with repositioning at a mean age of 4.8 months, the mean RDD was 0.55 cm (from an initial mean DD of 1.05 cm). For infants treated with cranial orthotics at a mean age of 6.6 months, the mean RDD was 0.71 cm (from an initial mean DD of 1.13 cm).
  
  
  CONCLUSIONS
  Infants treated with orthotics were older and required a longer length of treatment (4.2 vs 3.5 months). Infants treated with orthosis had a mean final DD closer to the DD in unaffected infants (0.3 +/- 0.1 cm), orthotic therapy was more effective than repositioning (61% decrease versus 52% decrease in DD), and early orthosis was significantly more effective than later orthosis (65% decrease versus 51% decrease in DD).
authors.affiliation: Medical Genetics Institute, Ahmanson Department of Pediatrics, Steven Spielberg Pediatric Research Center, Burns and Allen Research Institute, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Graham
authors.forename: Mayela
authors.initials: M
authors.lastname: Gomez
authors.forename: Andy
authors.initials: A
authors.lastname: Halberg
authors.forename: Dawn L
authors.initials: DL
authors.lastname: Earl
authors.forename: Jeannie T
authors.initials: JT
authors.lastname: Kreutzman
authors.forename: Jinrui
authors.initials: J
authors.lastname: Cui
authors.forename: Xiuqing
authors.initials: X
authors.lastname: Guo
mesh_terms: D000367:Age Factors; D005128:Eye Diseases / Q000209:etiology / Q000628:therapy; D005260:Female; D006260:Head Protective Devices; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D049068:Plagiocephaly, Nonsynostotic / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D012886:Skull / Q000002:abnormalities; D016683:Supine Position / Q000502:physiology*; D016896:Treatment Outcome