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A new parameter for the management of positional plagiocephaly: the size of the anterior fontanelle matters.
Wendling-Keim, Danielle S; Macé, Y; Lochbihler, H; Dietz, H-G; Lehner, Markus.
Afiliación
  • Wendling-Keim DS; Department of Pediatric Surgery, Dr. von Hauner Children's Hospital, Ludwig-Maximilian-University, Munich, Germany. Danielle.Wendling@med.uni-muenchen.de.
  • Macé Y; Department of Pediatric Surgery, Dr. von Hauner Children's Hospital, Ludwig-Maximilian-University, Munich, Germany.
  • Lochbihler H; Department of Pediatric Surgery, Zentralklinikum Augsburg, Augsburg, Germany.
  • Dietz HG; Department of Pediatric Surgery, Dr. von Hauner Children's Hospital, Ludwig-Maximilian-University, Munich, Germany.
  • Lehner M; Department of Pediatric Surgery, Dr. von Hauner Children's Hospital, Ludwig-Maximilian-University, Munich, Germany.
Childs Nerv Syst ; 36(2): 363-371, 2020 02.
Article en En | MEDLINE | ID: mdl-31209640
PURPOSE: The rate of positional plagiocephaly has increased since guidelines for the prevention of sudden infant death have led to the recommendation of positioning infants on their back during sleeping. Therapy includes repositioning, physiotherapy, and helmet therapy. To date, there is no consensus on the treatment of positional plagiocephaly. Therefore, it was the goal of this study to compare the results of physiotherapy and helmet therapy and to investigate if the size of the anterior fontanelle can be used as an additional parameter for the indication of the helmet therapy. METHODS: We enrolled 98 infants with a diagonal difference of 7 mm or more and plagiocephaly classified as Argenta II or more. Patients were grouped into infants with a small anterior fontanelle (< 25mm2) and infants with a large anterior fontanelle (≥ 25mm2). The patients were observed for at least 18 months. Sixty-eight patients were treated with repositioning and physiotherapy, whereas 30 infants received helmet therapy. RESULTS: The remolding rate was significantly higher with the helmet therapy than with physiotherapy. In patients with a small fontanelle, a lower spontaneous remolding rate was seen pointing to their lower correction potential. Especially in these patients, plagiocephaly was reduced significantly more quickly with the helmet treatment than with physiotherapy, so that they may benefit from the helmet due to their otherwise reduced spontaneous remolding capacity. CONCLUSION: The helmet therapy led to a faster reduction of the asymmetry than physiotherapy in this study. In patients with a small anterior fontanelle and therefore lower remolding potential, the helmet treatment was more effective than physiotherapy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Plagiocefalia no Sinostótica / Fontanelas Craneales Tipo de estudio: Guideline Límite: Child / Female / Humans / Infant / Male / Pregnancy Idioma: En Revista: Childs Nerv Syst Asunto de la revista: NEUROLOGIA / PEDIATRIA Año: 2020 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Plagiocefalia no Sinostótica / Fontanelas Craneales Tipo de estudio: Guideline Límite: Child / Female / Humans / Infant / Male / Pregnancy Idioma: En Revista: Childs Nerv Syst Asunto de la revista: NEUROLOGIA / PEDIATRIA Año: 2020 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania