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Surgical Correction of Sprengel's Deformity in Children Using the Modified Green Technique: A Functional and 3D
Philipp Scheider1, Fabian Unglaube2, Andreas Kranzl2
1Department of Pediatric Orthopaedics and Foot and Ankle Surgery, Orthopaedic Hospital Speising, 1130 Vienna, Austria.
Abstract:
Background/Objectives: Consensus exists on the effectiveness of surgery in improving scapular position and appearance in Sprengel's deformity, yet evidence regarding functional outcomes is limited. This study aimed to evaluate functional results of the modified Green procedure in children and to assess patient-reported outcome measures. Methods: Patients who underwent corrective surgery using the modified Green technique between 2006 and 2023 were analyzed. Demographic and treatment-specific parameters were collected. The clinical severity of the deformity was graded according to the Cavendish classification, and radiographic evaluation was performed using the Rigault classification. Therapeutic success with respect to mobility was determined by comparing pre- and postoperative abduction and elevation. Postoperative movement patterns of the upper limb were further evaluated using three-dimensional motion analysis. To quantify outcomes related to quality of life and functionality, standardized questionnaires were administered, including the Quick-DASH, the Shoulder Pain and Disability Index (SPADI), and the UCLA Shoulder Scale. Results: A total of 15 cases were included. The mean age at the time of surgery was 6.9 ± 4.0 years, with a mean follow-up of 4.8 ± 4.7 years (range, 0.6-17.7). Glenohumeral abduction improved to 90° in all cases, representing a mean gain of 8° (preoperatively: 82 ± 11°). Elevation improved by an average of 55° (preoperatively: 108 ± 28°; postoperatively: 163 ± 25°). At final follow-up, the mean Quick-DASH score was 10.7 ± 12.7, the mean SPADI score was 10.9 ± 12.1, and the mean UCLA Shoulder Scale was 31.9 ± 4.3, indicating excellent clinical outcomes. Conclusions: The modified Green procedure appears to be a safe and effective surgical technique for the correction of Sprengel's deformity in children, demonstrating favorable outcomes in terms of mobility, function, and quality of life in this cohort.
