title: High prevalence of cranial asymmetry exists in infants with neonatal brachial plexus palsy.
abstract: 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.
authors.affiliation: South Georgia Orthopedic Resources, Hiram, GA, USA.
authors.forename: Megan
authors.initials: M
authors.lastname: Tang
authors.affiliation: Access Prosthetics, Green Bay, WI, USA.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Gorbutt
authors.affiliation: Orthotics and Prosthetics Center, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Ammanath
authors.initials: A
authors.lastname: Peethambaran
authors.affiliation: Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Lynda
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Virginia S
authors.initials: VS
authors.lastname: Nelson
authors.affiliation: Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Kate Wan-Chu
authors.initials: KW
authors.lastname: Chang
mesh_terms: D001132:Arm / Q000503:physiopathology; D020516:Brachial Plexus Neuropathies / Q000150:complications* / Q000151:congenital / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D049068:Plagiocephaly, Nonsynostotic / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012075:Remission, Spontaneous; D012307:Risk Factors
keywords: Cranial asymmetry; neonatal brachial plexus palsy; positional plagiocephaly