Tang Megan, Gorbutt Kimberly A, Peethambaran Ammanath, Yang Lynda, Nelson Virginia S, Chang Kate Wan-Chu
South Georgia Orthopedic Resources, Hiram, GA, USA.
Access Prosthetics, Green Bay, WI, USA.
J Pediatr Rehabil Med. 2016 Nov 30;9(4):271-277. doi: 10.3233/PRM-160396.
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.
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.
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.
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.
本研究旨在：1）评估新生儿臂丛神经麻痹（NBPP）患儿颅骨不对称（体位性斜头畸形）的患病率；2）研究患者人口统计学特征、手臂功能及与NBPP相关的因素与体位性斜头畸形之间的关联；3）确定体位性斜头畸形自发恢复的百分比及其与手臂功能的关联。
本前瞻性横断面研究招募了年龄小于1岁、患有NBPP且既往未接受过头颅重塑治疗或手术干预的婴儿。使用玻璃纤维颅骨圆周模具测量体位性斜头畸形（对角线差异）。纳入的婴儿分为两组：1）在最近一次评估时患有体位性斜头畸形的婴儿（斜头畸形组），包括体位性斜头畸形已缓解的婴儿（斜头畸形缓解亚组）；2）从未患过体位性斜头畸形的婴儿（非斜头畸形组）。应用标准统计学方法。
28例婴儿中有18例（64%）患有体位性斜头畸形。分娩方式可能是斜头畸形的预测因素。非斜头畸形组婴儿的活动范围比斜头畸形组婴儿更大。所有其他因素均无显著相关性。
在所研究的NBPP人群中，体位性斜头畸形的患病率较高。家长和医生应鼓励婴儿使用上肢来改变姿势，以减少颅骨不对称的几率。
