Surgical Treatment for Sprengel Deformity

Abstract

Background & Objective: Sprengel deformity is a rare congenital deformity caused by undescended scapula in the embryo's life and is accompanied by complex pathological changes. The aim of this study was to assess long term results of Woodward procedure in treatment (in Children University Hospital) and to compare the results with international researches.

Materials &Methods: This retrospective study evaluated 31 children (42% male & 58% female) (average age 5.4 years) who had 35 cases of Sprengel deformity, and were treated surgically by Woodward procedure in Children University Hospital in Damascus between 2005 and 2015 and were followed-up for mean period of  76 months.

Results: Accessory omovertebral bone was gourd in 11 patients (35.48%), besides associated abnormalities in 9 patients (29%) containing 7 scoliosis, 6 ribs fusion, and 3 syndromes.

The only complication that we found was a deformed wide scar in 6 cases (17%). The final assessment showed average increase in Cavendish clinical classification by 1.66 degree (49.26%) and shoulder abduction by 47.8 degree, without recurrence.

Conclusion: Woodward procedure is a safe and effective surgical approach in the treatment of Sprengel deformity with good cosmetic and functional improvement. We emphasize that good planning and careful manipulation cancel the need for clavicular osteotomy which is usually used to prevent neurologic complication. Early shoulder movement and physical therapy is essential in functional improvement and recurrence prevention.

Key words: Sprengel’s deformity, congenital elevation of the scapula, congenital undescended scapula