Bilateral Sprengel's Deformity Treated with Bilateral Modified Woodward Procedure: A Case Report

Sprengel's deformity (SD) is a rare congenital scapular deformity, characterized by a small, elevated, or malpositioned scapula. Although it is rare, it is considered one of the most common congenital abnormalities of the shoulder in children. The scapula will be highly raised triangularly shaped, anteriorly and medially rotated, with limited scapulothoracic motion. As a result, patients will present with functional impairment, such as limited abduction and forward flexion, and cosmetic concerns. Various surgical approaches aiming for correction of SD have been established, including scapular osteotomy, parascapular muscles detachment and reattachment, and omovertebral bone resection. At present, Woodward procedure is among the most used surgical techniques to correct SD with good clinical outcomes. This aims for repositioning of the scapula and resection of the omovertebral bone or fibrous structures when identified, thereby enhancing both functional range of motion and cosmetic appearance. In this report, we present a case of a 6-year-old girl known to have Klippel-Feil Syndrome (KFS) with bilateral SD that was corrected by Bilateral Modified Woodward procedure simultaneously in a single operative setting.

We described a 6-year-old female child, a known case of KFS Type 2 with bilateral SD. Examination revealed bilaterally elevated scapulae with limited abduction. Imaging, including computed tomography, revealed bilateral SD, more pronounced on the left side, characterized by elevated and axially rotated scapulae. She underwent bilateral Modified Woodward's procedure done in the same operative setting in addition to anchoring the scapula to the relevant vertebrae.

Multiple surgical techniques have been described aiming to treat bilateral SD. In this case report, the patient was treated with bilateral Modified Woodward's procedure done in the same operative setting in addition to anchoring the scapula to the relevant vertebrae to reduce the risk of recurrence, which showed excellent intraoperative outcomes without any complications.