Children with positional plagiocephaly are seen in craniofacial clinics in alarming numbers. Treatment of children with significant positional plagiocephaly is with molding helmets. The unfortunate high cost of most custom molded helmets precludes many children from obtaining them. We have employed an adjustable, prefabricated molding helmet to treat these children that costs in the range of $600.00.

Methods: 199 patients with varying degrees of deformity were treated. 145 children completed the study. Improvement in cranial shape was rated by Argenta's classification and computerized surface Polhemus scanning laser. Patients were treated until a normal cranial shape was achieved.

Results: Average treatment time was 5.4 months. Success of treatment directly correlated with compliance (p=.0001). More severe deformities had the highest degree of compliance (p= .0148) and the greatest degree of improvement (p= <.0001). Fully compliant patients had the greatest reduction in severity.

Conclusion: Equally successful resolution of plagiocephaly deformities can be achieved at great cost savings and equal time with prefabricated, off the shelf helmets compared to custom fabricated orthosis. Compliance is critical to the success of treatment.