Efficiency of orthotic treatment in positional plagiocephaly

It is described the case of a 3 months old infant suffering from positional plagiocephaly secondary to supine decubitus long stay. The following clinical query was raised: in infants with positional plagiocephaly, cranial orthosis is more efficient than physiotherapy and positional changes - one of them or combined ?to achieve the complete solving of the deformity? Bibliographic search in TRIP and MEDLINE was carried out with the descriptors ?plagiocephaly? and ?Plagiocephaly, Nonsynostotic?. There were retrieved three documents: a systematic review, an evaluation report on sanitary technologies and a prospective series of cases. There were not retrieved any randomised clinical trial comparing both proceedings. From the critical appraisal of the scarce evidence found we conclude that it is adequate to begin positional plagiocephaly treatment with alternative changes of position (associated or not to physiotherapy if there is congenital torticollis also present), keeping back cranial orthosis for the resilient cases.