Plagiocephaly/Torticollis

Question 1

Plagiocephaly

Answer 1

Palgiocephaly - positional head shape deformity

• results in posterolateral flattening of the head, and bossing forwards of the forehead on the affected side
• results as skull is malleable

Question 2

Torticollis

Answer 2

Torticollis - shortening of SCM on one side

- either acquired during utero/birth or congenital

Question 3

Long term outcomes

Answer 3

not linked to impaired brain development
plagiocephaly normally resolves fully
may result in MSK changes and weakness

Question 4

Subjective Ax.

Answer 4

Prenatal history - consider oligohydramnios, multiples, positioning 
Birth history 
daily activities/positions for play 
baby equipment 
vision 
milestone achievement

Question 5

Objective Ax.

Answer 5

Cx AROM/PROM
head shape 
palpation 
hip screening 
foot screen 
objective tracking of head and eye movements 
do they turn to sound?
reflexes
parent handling

Question 6

Management

Answer 6

Educate parents and caregivers

• strengthen and position through the other direction
• importance of tummy and face time - place baby on chest so that they are facing you
• play positions
• pick up/put down through rolling
• carrying - bias the other side
• modify the environment to encourage rotation
• difficulty breast feeding = not time for exercise, accommodate for their ROM. Try football hold for opposite breast

Question 7

Red Flags

Answer 7

Craniosynotmosis - premature fusion of the sutures

• ear pulled back on the affected side
• ridging of sutures
• asymmetry in allignment/movement
• primitive reflexes either not present or not resolved
• vision/hearing issues
• parent mental health