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J Craniofac Surg. 2013 Mar;24(2):376-9. doi: 10.1097/SCS.0b013e31828010d1.

Correction of deformational plagiocephaly in early infancy using the plagio cradle orthotic.

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Department of Plastic and Reconstructive Surgery at Children's National Medical Center and George Washington School of Medicine, Washington, District of Columbia 20010, USA.



The purpose of this study was to assess early treatment of deformational plagiocephaly using the Plagio Cradle, a modifiable cranial orthotic.


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.


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).


The Plagio Cradle can fully correct deformational plagiocephaly early in life. Nevertheless, treatment is more effective if initiated before 10 weeks of age.

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