title: Correction of deformational plagiocephaly in early infancy using the plagio cradle orthotic.
abstract: BACKGROUND
  The purpose of this study was to assess early treatment of deformational plagiocephaly using the Plagio Cradle, a modifiable cranial orthotic.
  
  
  METHODS
  Infants were included if they had treatment of deformational plagiocephaly with the Plagio Cradle beginning at 4 months or younger. Patients were prospectively stratified by the age treatment was initiated: group 1: under 10 weeks (n = 50); group 2: 10 to 20 weeks (n = 113). Pretreatment and posttreatment calvarial asymmetry was measured using direct anthropometry and reported as a transcranial difference (TCD). The end point for therapy was a TCD of 5 mm or less, falling within 2 SDs of published normative data.
  
  
  RESULTS
  One hundred sixty-three infants were included. Initial TCD was significantly higher for group 1 as compared with group 2 (initial TCD: 11.0 vs 9.0 mm; P < 0.05). Duration of therapy was significantly longer for group 1 as compared with group 2 (6.9 vs 5.7 week; P < 0.05). Following cradle use, group 1 infants demonstrated a significantly larger change in TCD in comparison to group 2 (change in TCD: 6.0 vs 4.0 mm; P < 0.001). At the conclusion of therapy, group 1 infants trended toward greater calvarial symmetry than group 2 patients (final TCD: 4.5 vs 5.0 mm; P = 0.06) and a higher frequency of cases with full correction of asymmetry (62.4% vs 52.2%; P = 0.16).
  
  
  CONCLUSIONS
  The Plagio Cradle can fully correct deformational plagiocephaly early in life. Nevertheless, treatment is more effective if initiated before 10 weeks of age.
authors.affiliation: Department of Plastic and Reconstructive Surgery at Children's National Medical Center and George Washington School of Medicine, Washington, District of Columbia 20010, USA.
authors.forename: Mitchel
authors.initials: M
authors.lastname: Seruya
authors.forename: Albert K
authors.initials: AK
authors.lastname: Oh
authors.forename: Tina M
authors.initials: TM
authors.lastname: Sauerhammer
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Taylor
authors.forename: Gary F
authors.initials: GF
authors.lastname: Rogers
mesh_terms: D000886:Anthropometry; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009989:Orthotic Devices; D049068:Plagiocephaly, Nonsynostotic / Q000628:therapy*; D011446:Prospective Studies; D011474:Prosthesis Design; D016896:Treatment Outcome