Orteza kranialna jako metoda leczenia deformacji pozycyjnych

*Radim Lipina^{1, 2}, Eva Kaleta³, Jiří Rosický³, Štepánka Golová³, Martin Chlachula¹

Summary
Introduction. Abnormal cranial shapes in children that is caused by preferring one position of the head by neonates and infants, are called positional plagiocephaly. In infancy, the return of the correct shape may occur spontaneously or with the help of positioning treatment, however, in some cases, deformity persists into older age. The treatment of positional plagiocephaly is needed due to cosmetic and psychosocial reasons, as positional abnormalities as such do not affect the psychomotor development of children. Treatment options include positioning, physiotherapy, or cranial remodelling orthosis.
Aim. The aim of this study was to evaluate the results of the treatment with cranial remodelling orthosis.
Material and methods. 1182 children underwent treatment with cranial orthosis between January 2010 and June 2016, 1136 of whom tolerated the treatment well enough to receive full treatment. We evaluated the improvement of the cranial shape and examined its relationship with the patient’s age at the beginning of the therapy, length of treatment and type of positional deformity.
Results. The most common positional abnormality was asymmetric brachycephaly (78% of our patients), followed by plagiocephaly (10%) and symmetric brachycephaly (11%). All the patients with good tolerance of the orthosis presented with an improvement of the head shape. The best results were achieved when the treatment begun in an early age, between four and six months of age, and the period of wearing the orthosis was longer than 12 weeks. Complications included contact dermatitis (11 patients) and lymphatic oedema (2 patients).
Conclusions. Cranial orthosis treatment is a safe and effective method of treatment for the positional plagiocephaly, and, together with rehabilitation, it is an alternative to positioning. Results are dependent on the time of the start of the treatment and the length of treatment.

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