Long term results after correction of Sprengel’s deformity using the Woodward procedure

Abstract

Introduction: Sprengels deformity is a congenital anomaly of the shoulder with superior displacement and rotation of the hypoplastic scapula. The functional impairment and misshapen appearance of the shoulder can be minimized with different surgical techniques. The aim of this study was to evaluate the long term results after correction of Sprengel’s deformity using the Woodward procedure.Materials and Methods: In this study a total of 16 children with a congenital elevation of the scapula surgically treated for Sprengel deformity by Woodward’s procedure were enrolled. Outcome assessment was done by Range of motion, Constant score, DASH (disability of the arm, Shoulder and Hand) score and simple shoulder test (SST) were obtained to evaluate shoulder function. Scapula placement and degenerative disease were assessed by radiographic examination. Cavendish grading was used to evaluate cosmetic appearance at final review and were compared to those before surgery.Results: Abduction improved by 410 in the first year after surgery and with final improvement of 560 at long term follow-up. At the latest follow-up evaluation, the mean constant score was 85 points, the DASH score 14.59 points and the SST 9.5 points. Radiographs showed superior displacement of the involved scapula in all cases, with no signs of degenerative disease of the shoulder. Cavendish grade improved from grade 3 (pre-operatively) to grade 1 or 2 at the latest follow-up examination. Conclusion: Woodward procedure shows to be an effective surgical procedure to improve shoulder function as well as cosmetic appearance in patients with Sprengels deformity.