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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 augusti 2026 uppdaterad av: 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.

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Intervention / Behandling

Detaljerad beskrivning

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.

Studietyp

Observationell

Inskrivning (Beräknad)

19

Kontakter och platser

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Studiekontakt

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Studieorter

  • Turkiet (Türkiye)
      • Istanbul, Turkiet (Türkiye), 34668
        • University of Health Sciences Turkey, Fatih Sultan Mehmet Training and Research Hospital
        • Huvudutredare:
          • Esra Giray, MD
        • Kontakt:
        • Kontakt:
        • Underutredare:
          • Melike Nur Rençber, MD

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Barn

Tar emot friska volontärer

Nej

Testmetod

Icke-sannolikhetsprov

Studera befolkning

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

Beskrivning

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

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

Kohorter och interventioner

Grupp / Kohort
Intervention / Behandling
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.
Diagnostiskt test: Shoulder Ultrasonography
Ultrasonographic measurement of the shoulder alpha angle and percentage of humeral head displacement (PHHD), to be performed at each clinical visit.
Övrig: 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.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Ultrasonographic Alpha Angle
Tidsram: 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)
Tidsram: 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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Passive Range of Motion of the Shoulder and Elbow
Tidsram: 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
Tidsram: 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
Tidsram: 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)
Tidsram: 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
Tidsram: 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
Tidsram: 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

Samarbetspartners och utredare

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Sponsor

Fatih Sultan Mehmet Training and Research Hospital

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Beräknad)

1 augusti 2026

Primärt slutförande (Beräknad)

1 augusti 2027

Avslutad studie (Beräknad)

1 november 2027

Studieregistreringsdatum

Först inskickad

12 augusti 2026

Först inskickad som uppfyllde QC-kriterierna

12 augusti 2026

Första postat (Faktisk)

17 augusti 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

17 augusti 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

12 augusti 2026

Senast verifierad

1 augusti 2026

Mer information

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Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • 24/648

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