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Sprengel deformity.

S J Leibovic1, M G Ehrlich, D J Zaleske

  • 1Pediatric Orthopaedic Unit, Massachusetts General Hospital, Boston 02114.

The Journal of Bone and Joint Surgery. American Volume
|February 1, 1990
PubMed
Summary
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This study modified Green's procedure to treat Sprengel deformity, achieving significant shoulder abduction improvements. Surgical correction offers moderate to dramatic cosmetic results in pediatric patients.

Area of Science:

  • Orthopedic Surgery
  • Pediatric Orthopedics
  • Skeletal Dysplasias

Background:

  • Sprengel deformity is a rare congenital condition characterized by the elevated scapula.
  • Treatment aims to improve shoulder function and cosmetic appearance.
  • Previous surgical techniques have varied in efficacy and complexity.

Purpose of the Study:

  • To evaluate the outcomes of a modified Green's procedure for Sprengel deformity.
  • To assess functional and cosmetic improvements following surgical intervention.
  • To analyze radiographic changes in scapular position and rotation.

Main Methods:

  • A modified Green's procedure was performed on sixteen patients (eighteen cases) with Sprengel deformity.
  • The technique involved freeing muscular attachments, cutting the omovertebral band, and repositioning the scapula.

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  • Radiographic analysis quantified scapular lowering and derotation; shoulder abduction was measured pre- and post-operatively.
  • Main Results:

    • Eleven of fifteen available patients showed moderate to dramatic cosmetic improvement.
    • Average shoulder abduction increased from 91 degrees preoperatively to 148 degrees postoperatively.
    • Initial scapular derotation was achieved, though recurrence was noted after two years without compromising abduction gains.

    Conclusions:

    • The modified Green's procedure is an effective surgical option for Sprengel deformity, yielding significant functional and cosmetic benefits.
    • While initial derotation may not be permanent, the procedure reliably improves shoulder abduction.
    • This surgical approach offers a viable alternative without requiring external traction devices.