Evidence-Based Care of the Child With Deformational Plagiocephaly, Part II: Management

Flannery, Amanda B. Kack; Looman, Wendy S.; Kemper, Kristin

doi:10.1016/j.pedhc.2011.10.002

Cited by 57 publications

(47 citation statements)

References 43 publications

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“…A subsequent review, published in 2012, examining 20 studies of molding helmet therapy concluded that no study had indicated that any harm was associated with this intervention. 5 A large prospective study of 260 patients treated with custom helmets reported a morbidity rate of 0%. 4 Several studies in which cohorts of patients with positional plagiocephaly were treated with various custom or noncustom orthoses reported no treatment-associated complications, including series of 159 patients, 28 patients, 71 patients, 29 patients, 125 patients, 116 patients, 105 patients, and a 97 patient study that also noted that patients with severe brachycephaly can be difficult to fit in orthoses due to poor helmet purchase on a flattened external occipital protuberance.…”

Section: Resultsmentioning

confidence: 99%

Complications associated with molding helmet therapy for positional plagiocephaly: a review

Gump

Mutchnick²,

Moriarty³

2013

FOC

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Molding helmet therapy is a widely accepted treatment for positional plagiocephaly that is generally considered to be low risk. Multiple large outcome studies have shown good results, but adverse events are rarely reported. The literature on helmet therapy was reviewed to clarify the clinical experience with associated complications. Although significant complications were extremely rare, there was a large degree of variability in detection of lesser problems such as minor skin irritation. Patients with a primarily brachycephalic morphology may be at higher risk for poorly fitting orthoses. Most reported complications are minor and self-limited. Maintenance of good helmet hygiene appears to be the most effective strategy for reducing or eliminating complications.

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Section: Resultsmentioning

confidence: 99%

Complications associated with molding helmet therapy for positional plagiocephaly: a review

Gump

Mutchnick²,

Moriarty³

2013

FOC

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“…Six articles were excluded because they were not directly related to cranial orthoses therapy in deformational plagiocephaly (n = 5), or involved nonhuman subjects (n = 1). Of the remaining 36 papers, 21 were primary research literature articles, 5,6,[9][10][11][12][13][14][15][16][17]20,25,26,31,33,[35][36][37]39,41 12 were reviews, 7,8,[22][23][24]29,30,32,34,38,40,42 2 were letters, 3,18 and 1 described the methodology of an ongoing randomized controlled trial. 43 Of the 21 primary research articles, there were 7 Class II studies, 10,11,13,17,25,31,36 1 Class III study, 33 and 13 Class IV studies.…”

Section: Resultsmentioning

confidence: 99%

Orthotic (helmet) therapy in the treatment of plagiocephaly

Goh

Bauer²,

Durham³

et al. 2013

FOC

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Object The goal of this study was to review the current literature on orthotic (helmet) therapy use in the treatment of deformational plagiocephaly. Methods PubMed was used to search English articles using the medical subject headings “deformational plagiocephaly” and “orthosis,” and “deformational plagiocephaly” and “helmet.” Results Forty-two articles were found. There were no Class I studies, 7 Class II studies, 1 Class III study, and 13 Class IV studies. Cranial orthoses have been shown to be effective in treating deformational plagiocephaly. It continues to be debated as to whether the statistical significance of treatment with cranial orthoses compared with conservative therapies is clinically significant. Children older than 12 months of age with deformational plagiocephaly may still benefit from orthotic therapy. The long-term effects of orthotic therapy are controversial. Conclusions There is a lack of Class I literature evidence supporting the use of helmet therapy in deformational plagiocephaly. There are controversies surrounding the use of orthotic therapy such as appropriate use, cost, use in older children, and long-term outcomes. Clinical indications for orthotic therapy need to be better defined with further research studies.

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“…Abnormal forces early in development may permanently alter structural relationships [Dunn, 1976]. When abnormal mechanical forces have been present over a prolonged period of time, a deformation may be more difficult to correct [Christianson et al, 1999;Flannery et al, 2012]. Deformations are usually reversible postnatally depending on how longstanding they are and how much growth has occurred subsequent to the initial compressive forces [Graham et al, 1979;Graham, 1988;Van Allen et al, 1994;Levine et al, 1996].…”

Section: Deformationmentioning

confidence: 99%

Elements of morphology: General terms for congenital anomalies

Hennekam

Biesecker

Allanson

et al. 2013

American J of Med Genetics Pt A

118

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An international group of clinicians working in the field of dysmorphology has established a process for the standardization of terms used to describe human morphology. The goals are to standardize these terms and develop consensus regarding their definitions. This project will increase the usefulness and precision of descriptions of the human phenotype and facilitate reliable comparisons of phenotypic findings among clinicians and researchers in medicine, developmental biology, and genetics. Here we define and illustrate the general terms that describe congenital anomalies as related to human conditions.

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Evidence-Based Care of the Child With Deformational Plagiocephaly, Part II: Management

Cited by 57 publications

References 43 publications

Complications associated with molding helmet therapy for positional plagiocephaly: a review

Complications associated with molding helmet therapy for positional plagiocephaly: a review

Orthotic (helmet) therapy in the treatment of plagiocephaly

Elements of morphology: General terms for congenital anomalies

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