Congenital elevation of the scapula: surgical treatment with Mears technique

Several procedures have been described for the treatment of congenital elevation of the scapula. The method proposed by Mears in 2001 seems to provide highly favorable functional and cosmetic results. To date, there are no studies in literature that supported the initial results obtained by this author. The aim of our study is to evaluate the appearance and range of motion obtained with Mears technique.

We evaluated prospectively 21 consecutive patients treated from June 2001 to June 2006. Fourteen of them (5 males and 9 females) with Cavendish grade III and IV were treated with said technique. Mean age was 6.7 years (range, 4-10 years). Mean follow-up was 45 months (range, 12-74 months). The operative results were evaluated on cosmetic and functional criteria. Functional evaluation includes preoperative and postoperative range of motion and strength. Appearance evaluation was performed according to Cavendish Scale.

Range of motion improved significantly. On average, flexion improved from 83.9 degrees (range, 50-120 degrees) to 152.1 degrees (range, 110-180 degrees) (P < 0.001), and abduction improved from 81 degrees (range, 50-120 degrees) to 145 degrees (range, 100-180 degrees) (P < 0.001). Appearance improved by a mean of 2 levels on the Cavendish Scale. In 2 patients, a second operation was performed to remove a residual exostosis. Two patients developed keloid scars. All patients expressed satisfaction with operative results.

Mears technique provides significant improvement in range of motion and a considerable appearance improvement with a low morbidity. Further clinical experience will be needed to confirm these outcomes.