Affiliations: [a] South Georgia Orthopedic Resources, Hiram, GA, USA | [b] Access Prosthetics, Green Bay, WI, USA | [c] Orthotics and Prosthetics Center, University of Michigan, Ann Arbor, MI, USA | [d] Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA | [e] Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
Correspondence:
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Corresponding author: Kate Wan-Chu Chang, Department of Neurosurgery, University of Michigan, 1500 E. Medical Center Drive, 3552 Taubman Center, Ann Arbor, MI 48109-5338, USA. Tel.: +1 734 936 5017; Fax: +1 734 936 9294; E-mail:katewc@med.umich.edu
Abstract: PURPOSE: This study aimed to: 1) evaluate the prevalence of cranial
asymmetry (positional plagiocephaly) in infants with neonatal brachial
plexus palsy (NBPP); 2) examine the association of patient demographics, arm
function, and NBPP-related factors to positional plagiocephaly; and 3)
determine percentage of spontaneous recovery from positional plagiocephaly
and its association with arm function. METHODS: Infants < 1 year of age with NBPP and no previous
exposure to plagiocephaly cranial remolding therapy or surgical intervention
were recruited for this prospective cross-sectional study. Positional
plagiocephaly (diagonal difference) measurements were captured using a
fiberglass circumferential mold of the cranium. Included infants were
divided into 2 groups: 1) those with positional plagiocephaly at most recent
evaluation (plagio group), including infants with resolved positional
plagiocephaly (plagio-resolved subgroup); and 2) those who never had
positional plagiocephaly (non-plagio group). Standard statistics were
applied. RESULTS: Eighteen of 28 infants (64%) had positional
plagiocephaly. Delivery type might be predictive for plagiocephaly. Infants
in the non-plagio group exhibited more active range of motion than infants
in the plagio group. All other factors had no significant correlations. CONCLUSIONS: A high prevalence of positional plagiocephaly exists
among the NBPP population examined. Parents and physicians should encourage
infants to use their upper extremities to change position and reduce chance
of cranial asymmetry.
