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Investigation of the Relationship Between Shoulder Alpha Angle and Humeral Head Displacement Percentage Measured by Ultrasonography in Neonatal Brachial Plexus Palsy Infants With Clinical Parameters

12 augustus 2026 bijgewerkt door: Fatih Sultan Mehmet Training and Research Hospital
This study will examine infants with a birth-related nerve injury called neonatal brachial plexus palsy, which can affect movement in the arm and sometimes cause the shoulder joint to shift out of its normal position (subluxation). Researchers will use ultrasound imaging to measure the shoulder joint and will compare these measurements with findings from a physical examination, to determine which clinical signs can help predict whether a baby's shoulder will develop this problem. The goal is to help doctors detect shoulder problems earlier, so that treatment can start sooner.

Studie Overzicht

Toestand

Nog niet aan het werven

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

Infants aged 3 months to 1 year with neonatal brachial plexus injury (Narakas Group I-III) will be evaluated at a single pediatric rehabilitation clinic. At each visit, the same physiatrist will perform a standardized clinical examination, including assessment of demographic and obstetric history, subluxation-specific clinical signs (axillary skin fold asymmetry, palpable posterior fullness), passive range of motion, upper extremity length discrepancy, the Active Movement Scale, and the Toronto Test Score. A second physiatrist, blinded to clinical findings, will perform shoulder ultrasonographic evaluation using a posterior approach to measure the alpha angle and the percentage of humeral head displacement (PHHD). Glenohumeral subluxation will be defined as an alpha angle greater than 30 degrees; dislocation will be defined as an alpha angle greater than 30 degrees combined with PHHD greater than 50%. Associations between clinical findings and ultrasonographic subluxation will be analyzed using Generalized Linear Mixed Models to account for repeated measurements per patient, followed by ROC curve analysis to identify optimal predictive thresholds.

Studietype

Observationeel

Inschrijving (Geschat)

19

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Contact Back-up

Studie Locaties

  • Turkije (Türkiye)
      • Istanbul, Turkije (Türkiye), 34668
        • University of Health Sciences Turkey, Fatih Sultan Mehmet Training and Research Hospital
        • Hoofdonderzoeker:
          • Esra Giray, MD
        • Contact:
        • Contact:
        • Onderonderzoeker:
          • Melike Nur Rençber, MD

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

  • Kind

Accepteert gezonde vrijwilligers

Nee

Bemonsteringsmethode

Niet-waarschijnlijkheidssteekproef

Studie Bevolking

Infants diagnosed with neonatal brachial plexus injury who present to the Pediatric Rehabilitation Clinic of the University of Health Sciences Turkey, Fatih Sultan Mehmet Training and Research Hospital, and who meet the eligibility criteria, will be consecutively enrolled in the study

Beschrijving

Inclusion Criteria:

  • Diagnosis of neonatal brachial plexus injury (NBPI) between 3 months and 1 year of age
  • Narakas classification Group I, II, or III
  • Absence of nerve root avulsion

Exclusion Criteria:

  • Prior shoulder surgery for NBPI
  • Inability to tolerate ultrasonographic examination
  • Concomitant musculoskeletal (e.g., torticollis, humeral fracture) or neurological disease
  • Bilateral NBPI
  • Narakas classification Group IV
  • Botulinum toxin injection to the affected shoulder

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

Cohorten en interventies

Groep / Cohort
Interventie / Behandeling
Infants with Neonatal Brachial Plexus Palsy
Infants aged 3 months to 1 year with neonatal brachial plexus injury (Narakas Group I-III) who will undergo standardized clinical examination and shoulder ultrasonographic evaluation at each visit.
Diagnostische toets: Shoulder Ultrasonography
Ultrasonographic measurement of the shoulder alpha angle and percentage of humeral head displacement (PHHD), to be performed at each clinical visit.
Ander: Standardized Clinical Examination
Standardized physical examination including passive range of motion, Active Movement Scale, Toronto Test Score, and subluxation-specific clinical signs, to be performed at each visit.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Ultrasonographic Alpha Angle
Tijdsspanne: Assessed at each clinical visit from 3 months to 1 year of age
Alpha angle will be measured sonographically at each shoulder examination. Glenohumeral subluxation will be defined as an alpha angle greater than 30 degrees.
Assessed at each clinical visit from 3 months to 1 year of age
Percentage of Humeral Head Displacement (PHHD)
Tijdsspanne: Assessed at each clinical visit from 3 months to 1 year of age
PHHD will be measured sonographically at each shoulder examination. Glenohumeral dislocation will be defined as an alpha angle greater than 30 degrees combined with PHHD greater than 50%.
Assessed at each clinical visit from 3 months to 1 year of age

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Passive Range of Motion of the Shoulder and Elbow
Tijdsspanne: Assessed at each clinical visit from 3 months to 1 year of age
Passive range of motion of the shoulder (flexion, extension, abduction, internal and external rotation) and elbow (flexion, extension) will be measured using standard goniometry at each visit and evaluated for association with glenohumeral subluxation.
Assessed at each clinical visit from 3 months to 1 year of age
Active Movement Scale (AMS) Score
Tijdsspanne: Assessed at each clinical visit from 3 months to 1 year of age
AMS score will be assessed at each visit as a clinical predictor of glenohumeral subluxation.
Assessed at each clinical visit from 3 months to 1 year of age
Toronto Test Score
Tijdsspanne: Assessed at each clinical visit from 3 months to 1 year of age
Toronto Test Score will be calculated at each visit and evaluated for association with glenohumeral subluxation.
Assessed at each clinical visit from 3 months to 1 year of age
Subluxation-Specific Clinical Signs (Axillary Skin Fold Asymmetry and Palpable Posterior Fullness)
Tijdsspanne: Assessed at each clinical visit from 3 months to 1 year of age
Presence of axillary skin fold asymmetry and palpable posterior shoulder fullness will be assessed at each visit and evaluated for association with glenohumeral subluxation.
Assessed at each clinical visit from 3 months to 1 year of age
Upper Extremity Length Discrepancy
Tijdsspanne: Assessed at each clinical visit from 3 months to 1 year of age
Difference in upper extremity length between the affected and unaffected sides will be measured at each visit and evaluated for association with glenohumeral subluxation.
Assessed at each clinical visit from 3 months to 1 year of age
Reinnervation Status
Tijdsspanne: Assessed at each clinical visit from 3 months to 1 year of age
Neurological reinnervation status (full, partial, or none) will be assessed at each visit relative to the prior visit.
Assessed at each clinical visit from 3 months to 1 year of age

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Fatih Sultan Mehmet Training and Research Hospital

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Geschat)

1 augustus 2026

Primaire voltooiing (Geschat)

1 augustus 2027

Studie voltooiing (Geschat)

1 november 2027

Studieregistratiedata

Eerst ingediend

12 augustus 2026

Eerst ingediend dat voldeed aan de QC-criteria

12 augustus 2026

Eerst geplaatst (Werkelijk)

17 augustus 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

17 augustus 2026

Laatste update ingediend die voldeed aan QC-criteria

12 augustus 2026

Laatst geverifieerd

1 augustus 2026

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • 24/648

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