Abstract: Background: Orthopedic outcomes after craniosynostosis surgery are dependent on helmet orthopedic treatment. Objective: To investigate the effect of continuing treatment with an orthopedic helmet in children with non-syndromic craniosynostosis after surgery. Design: Case series report. Methods: A retrospective analysis was performed for clinical data of children with non-syndromic craniosynostosis who underwent continuous correction with orthopedic helmets at the Children's Health and Development Center of Peking University Third Hospital from January 2019 to December 2021. Main outcome measures: Head circumference, cranial asymmetry index (CVAI) and cranial ratio (CR). Results: Forty-five children with non-syndromic craniosynostosis treated with orthopedic helmets were included in the analysis with 24 males and 21 females. There were 16 cases of premature closure of the coronal suture, 18 cases of premature closure of the sagittal suture, 9 cases of premature closure of the herringbone suture, and 2 cases of premature closure of the frontal suture. Before wearing the orthopedic helmet, 15 cases were diagnosed as plagiocephaly, 6 cases as brachycephaly, 16 cases as scaphocephaly, 5 cases as asymmetric brachycephaly and 3 cases of normal skull shape. Minimally invasive craniosynostosis was performed in 12 cases, and craniotomy and cranial remodeling were performed in 33 cases. The average age at operation was 8.5 (6, 12) months. The average time to start wearing the orthopedic helmet was 20 (14, 26) d after surgery, and the average wearing time was 7 (4.5, 10) months. All 45 children were able to wear the orthopedic helmet as required, with a median follow-up time of 7.5 (5, 10.5) months. Compared with the before, significant improvement was identified in head circumference ［(445±10.5) mm vs (469±6.5) mm］ for all 45 children, CVAI of children with plagiocephaly ［(6.1±2.5) vs (3.1±1.2)］, CR in children with brachycephaly ［(0.95±0.08) vs (0.82±0.06)］ and CR in children with scaphocephaly ［(0.72±0.02) vs (0.79±0.03)］ after 2-week orthopedic helmet wearing. Forty-one cases completed neuromotor and psychological development scoring at the age of 12 to 24 months, with an average score of (97.9±7.5), all of which were within the normal range. There were no complications such as skin ulcer necrosis, severe rash, and skin allergy. Conclusions: After non-syndromic craniosynostosis, the orthopedic helmet has a positive effect on the treatment of cranial abnormalities, and it is safe and will not cause head growth restriction.

Key words: Premature cranial suture closure, Orthopedic helmet, Infant