Factors Associated with Helmet Therapy Outcomes in Positional Plagiocephaly

Area of Science:

• Pediatric orthopedics
• Cranial development
• Infant health

Background:

• Positional plagiocephaly is a common condition in infants.
• Helmet therapy is a primary treatment for positional plagiocephaly.
• The influence of anterior fontanelle size on helmet therapy outcomes is not well-established.

Purpose of the Study:

• To investigate the impact of anterior fontanelle size on helmet therapy effectiveness.
• To determine if anterior fontanelle size influences treatment outcomes for positional plagiocephaly.
• To identify optimal patient criteria and timing for helmet therapy.

Main Methods:

• Retrospective study of 94 infants with positional plagiocephaly treated with helmet therapy.
• Patients categorized by age (≤6 months vs. >6 months) and anterior fontanelle size quartiles.
• Cranial vault asymmetry (CVA) and cranial vault asymmetry index (CVAI) measured pre- and post-treatment.

Main Results:

• Infants aged ≤6 months demonstrated significantly greater improvement in CVA and CVAI compared to older infants.
• No significant differences in treatment outcomes were observed based on anterior fontanelle size quartiles.
• Age at the start of treatment is a more critical factor than anterior fontanelle size.

Conclusions:

• Anterior fontanelle size is not a predictor of helmet therapy outcomes in positional plagiocephaly.
• Early initiation of helmet therapy (≤6 months) is the most critical factor for optimal results.
• Age, not anterior fontanelle size, should guide treatment decisions for positional plagiocephaly.