Sandeep Patwardhan1, Vivek Sodhai2, Sunny Gugale1, Parag Sancheti1, Ashok Shyam1,3. 1. Sancheti Institute for Orthopaedics and Rehabilitation, 16, Shivaji Nagar, Pune, 411005, India. 2. Sancheti Institute for Orthopaedics and Rehabilitation, 16, Shivaji Nagar, Pune, 411005, India. vivek.sodhai89@gmail.com. 3. Indian Orthopaedic Research Group, Thane, India.
Abstract
PURPOSE: Sprengel's deformity is a congenital failure of the descent of the scapula with main concerns regarding cosmetic deformity and restricted function of the affected shoulder. The purpose of this study was to present the results of Modified Woodward procedure in 28 patients with Sprengel's shoulder. METHODS: Twenty-eight patients (9 males, 19 females) of Sprengel's shoulder treated with modified Woodward procedure from 2010 to 2016 were retrospectively studied. Clinical assessment was done using Cavendish grading and Rigault's classification for radiographic evaluation. RESULTS: Mean age at the time of surgery was six years and three months. Mean follow-up was 20 months. We found a mean increase in abduction of 34.2° (15-50) and flexion of 20.6° (10-25), mean scapular lowering of 2.3 cm (0.5-4.5 cm), and a Cavendish grade I in 18 (65%), grade II in 10 (35%). Thus, we had 65% satisfactory results in terms of cosmesis and 85% with the function of the affected limb. Rigault grading improved by one grade in 16 children and by two grades in 12 children. Subjectively, all parents were satisfied with the cosmetic appearance of the achieved scapular lowering. We had one case of delayed superficial wound healing which resolved spontaneously. CONCLUSION: Modified Woodward procedure for Sprengel's shoulder deformity gives good cosmetic correction and improvement in shoulder function with minimal complications. This procedure is good for selective cases of Cavendish grade II with cosmetic concerns and all cases of Cavendish grade III and IV.
PURPOSE: Sprengel's deformity is a congenital failure of the descent of the scapula with main concerns regarding cosmetic deformity and restricted function of the affected shoulder. The purpose of this study was to present the results of Modified Woodward procedure in 28 patients with Sprengel's shoulder. METHODS: Twenty-eight patients (9 males, 19 females) of Sprengel's shoulder treated with modified Woodward procedure from 2010 to 2016 were retrospectively studied. Clinical assessment was done using Cavendish grading and Rigault's classification for radiographic evaluation. RESULTS: Mean age at the time of surgery was six years and three months. Mean follow-up was 20 months. We found a mean increase in abduction of 34.2° (15-50) and flexion of 20.6° (10-25), mean scapular lowering of 2.3 cm (0.5-4.5 cm), and a Cavendish grade I in 18 (65%), grade II in 10 (35%). Thus, we had 65% satisfactory results in terms of cosmesis and 85% with the function of the affected limb. Rigault grading improved by one grade in 16 children and by two grades in 12 children. Subjectively, all parents were satisfied with the cosmetic appearance of the achieved scapular lowering. We had one case of delayed superficial wound healing which resolved spontaneously. CONCLUSION: Modified Woodward procedure for Sprengel's shoulder deformity gives good cosmetic correction and improvement in shoulder function with minimal complications. This procedure is good for selective cases of Cavendish grade II with cosmetic concerns and all cases of Cavendish grade III and IV.
Entities:
Keywords:
Congenital high scapula; Modified Woodward procedure; Sprengel’s shoulder
Authors: Paola Zarantonello; Giovanni Luigi Di Gennaro; Marco Todisco; Piergiorgio Cataldi; Stefano Stallone; Andrea Evangelista; Daniele Ferrari; Diego Antonioli; Giovanni Trisolino Journal: Children (Basel) Date: 2021-12-06