NARRATIVE REVIEW ON POSITIONAL PLAGIOCEPHALY

E. Xhajanka¹, I.R. Bordea² , P. Avantario³, A.D. Inchingolo³, A.M. Inchingolo³, A. Laforgia³, S.R. Tari⁴, C. Bugea³, F. Postiglione³, F. Inchingolo³, G. Dipalma³

¹ Department of Dental Prosthesis, Medical University of Tirana, Rruga e Dibrës, U.M.T., Tirana, Albania
² Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
³ Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Bari, Italy
⁴ Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, Italy

Correspondence to:

Journal of Orthopedics 2023 September-December; 15(3): 154-160

Received: 19 October 2023 Accepted: 8 November 2023

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Abstract

Plagiocephaly, characterized by asymmetrical skull distortion, affects infants and can manifest in various severities, impacting both aesthetics and cranial function. Historically linked to cultural practices like cradleboarding, modern medicine now focuses on its pathological aspects. Plagiocephaly is primarily categorized into synostotic plagiocephaly, caused by premature cranial suture fusion requiring surgical intervention, and positional plagiocephaly (PP), resulting from external pressures and managed through non-surgical methods. The prevalence of PP has increased since the 1990s due to the “Back to Sleep” campaign aimed at reducing sudden infant death syndrome, leading to prolonged supine positioning. PP affects approximately 20% of infants, with higher incidence in males, preterm infants, and those with limited neck mobility. Clinical significance extends beyond cosmetic concerns, potentially impacting cranial development, auditory and visual alignment, and cognitive development. Prevention involves maternal nutrition, safe sleeping practices, tummy time, repositioning, and parental education. Argenta’s classification system categorizes PP severity, guiding intervention strategies from repositioning and physical therapy to helmet therapy and, rarely, surgical intervention. Challenges include parental awareness, cost, and adherence to preventive measures. Current research focuses on advanced diagnostic imaging, innovative treatments, and understanding long-term outcomes, emphasizing the importance of early detection and intervention for optimal cranial development.

Keywords: cranial deformation, flat head, infant cranial development, infant well-being, positional plagiocephaly, rigid mattress, semi-rigid mattress