Prevalence of shoulder subluxation diagnosed via ultrasound screening in infants with birth brachial plexus…

Cohort studyPM & R : the journal of injury, function, and rehabilitation· Aug 2026

Prevalence of shoulder subluxation diagnosed via ultrasound screening in infants with birth brachial plexus injuries.

Gabrielle Goodlin, Sarah Lewis, Sarah Menashe … Marisa Osorio

Read paper

Musculoskeletal ImagingCohort studyDiagnosis

Shoulder subluxation found in 83.3% of infants with brachial plexus palsy by 3 months

Prevalence of shoulder subluxation diagnosed via ultrasound screening in infants with birth brachial plexus injuries.

Gabrielle Goodlin … Marisa Osorio

PM & R · Aug 2026

Background

Posterior shoulder subluxation and glenohumeral dysplasia are known secondary complications of birth brachial plexus palsies (birth brachial plexus palsies) that contribute to functional limitations.

Purpose

To determine the prevalence of posterior shoulder subluxation in infants with birth brachial plexus palsies and persistent neurological deficits with universal ultrasound screening.

Methods

114 infants with birth brachial plexus palsies referred to a multidisciplinary brachial plexus clinic between 2011 and 2023 with persistent neurological deficits beyond neurapraxic injuries.

n = 114 infants

Results

83.3% of infants had shoulder subluxation on ultrasound screening at 3 months old

β -0.60 (95% CI -0.76 to -0.31)

null 0

-0.76

-0.31

CI excludes the null - significant

More results

Sixty-six patients (57.9%) had alpha angles ≥40 degrees (severe).

The mean alpha angle for the affected shoulder was 45.57 (SD 17.12), and 26.92 (SD 5.84) for the contralateral unaffected shoulder.

More results

On linear regression, decreased PROM with shoulder external rotation in adduction was correlated with higher alpha angle measurements (β = -0.599, 95% CI -0.758 to -0.308, r = -0.484, p < .001).

Of the patients with normal PROM-ER, 74.6% (50 patients) had shoulder subluxation on imaging.

“

Conclusion · 1 of 2

The prevalence of shoulder subluxation is much higher than previously reported in the literature. Over half of patients with subluxation on imaging have no PROM deficits on exam.

Conclusion · 2 of 2

Multicenter prospective longitudinal data are needed to further evaluate if early detection of shoulder subluxation allows for timely intervention and treatment for joint preservation.

Prevalence of shoulder subluxation diagnosed via ultrasound screening in infants with birth brachial plexus injuries.

Prevalence of shoulder subluxation diagnosed via ultrasound screening in infants with birth brachial plexus injuries.

Related papers