The incidence of deformational plagiocephaly greatly increased with the implication of the “back to sleep” campaign. The purpose of this study was to observe and report on the results of the treatment of 300 patients with deformational plagiocephaly at a single institution from 1998-2003.

Children with a preliminary diagnosis of plagiocephaly underwent a thorough history and physical. Every patient was then placed in one of our four categories of deformational plagiocephaly and given a trial of position and neck exercises. If there is no change in physical exam in two months time, then a three-dimensional CT of the head is performed to determine the nature of the sutures. Those without change were placed in a molding helmet for three to six months.

Depending on the type of plagiocephaly and the presence of torticollis, many patients responded to positioning changes or neck physical therapy. Certain subtypes of patients required the use of molding helmets.

The following conclusions can be made from our study. Non-synostotic plagiocephaly appears to have four distinct forms. Torticollis is frequently associated. Computed tomography and careful observations are essential for proper diagnosis. Proactive early interventions can reduce the long-term deformity. Proper classification appears to influence treatment effectiveness.