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June 26 2013,Advancements In Orthotic Technology For The Lower Limb & Orthotic Management of the High Tone Patient
It is not uncommon for babies to be born with an asymmetric head shape, or to acquire the condition as a result of sleep habits or crib placement. If this condition persists, the child may have something known as positional plagiocephaly. If a child’s head shape has not improved and become reasonably symmetrical by three months of age, experts often recommend corrective intervention.
Positional plagiocephaly could be related to restrictions in the womb, premature birth, preferred infant positioning, torticollis or other pathologic conditions.
Diagnosing Positional Plagiocephaly
Our practitioners, Lizz Peterson L.O., C.O., and Amanda Pozarnsky L.P.O., C.P.O., specialize in the orthotic treatment of positional plagiocephaly. Treatment may include parental education on infant repositioning techniques, and/or a cranial remolding orthosis.
During our evaluation, we complete a laser scan of the infant’s head, which allows us to determine the extent of the cranial asymmetry. There is no radiation exposure involved in this non-invasive, eye-safe scan, which takes less than 2 seconds to perform in our office. Scans also can be done to quantify progress when repositioning is recommended.
Westcoast Brace & Limb works closely with area craniofacial surgeons, neurologists and neurosurgeons. If a definitive diagnosis of a child’s condition has not been determined, we would be happy to refer you to one of these medical professionals for a consultation.
Common Signs of Positional Plagiocephaly
- When viewing from the top, the head presents a parallelogram shape
- The child’s eyes and ears are not aligned
- One cheek appears to be smaller than the other
- The child presents with an angled forehead
- The top or the back of the head slopes in one direction
With plagiocephaly, early intervention is the key to a successful treatment plan. Our Starband™ cranial orthoses are FDA approved. Topographical scans are obtained at our office using the STARscanner™, a non-invasive, non-radiation scanning device. The use of a computerized scanner eliminates the plaster casting process, previously required in order to fabricate the orthosis.
Will the Head Shape Self-Correct?
An asymmetric head shape is a common result of vaginal delivery. In these cases, the head shape will normally improve without intervention after several hours to several weeks post-partum. However, it is important to recognize the possibility that this situation may not improve and intervention could be required.
After a model of the infant’s head is created from the topographical scan, a custom orthosis is fabricated using a rigid thermoplastic material with a soft liner. The liner allows for gradual adjustments to guide growth and promote symmetry of the skull.
The treatment lasts an average of 16-weeks and the helmet is worn 23-hours a day. Cranial remolding orthoses may be indicated for children between 4-18 months of age. The best results are achieved when treatment is initiated between 4 and 7 months.
What to Expect
When parents call Westcoast Brace & Limb with cranial remolding questions, they will be directed to Diane Gignac, Orthotic Case Manager. Diane has been with Westcoast Brace & Limb for over 11 years and possesses a wealth of knowledge relating to insurance coverage and the cranial remolding fabrication process. Diane will check insurance benefits, obtain authorization when necessary, and inform parents of any financial responsibility. Payment arrangements are available.
The first appointment:
Evaluation, measurements, scanning with the Starscanner™ system, clinical photographs, and parental education.
(Approximately 10 days after evaluation)
The infant is fit with the cranial band and parents are instructed on wear/care procedure. This appointment will take approximately one hour. It is best to leave siblings at home for this appointment, so that the parent can be fully focused on the infant’s needs.
Measurements are taken at every follow-up visit and the cranial band is modified to accommodate growth. The number of visits will depend on how long the infant will need to wear the cranial band. Follow-up appointments are done bi-weekly, or in some cases weekly, depending on the age of the infant.
Please contact Westcoast Brace & Limb’s Cranial Remolding Team for more information:
Orthotic Case Manager
(813) 985-5000 extension 240