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Published on: November 8, 2024
The modified woodward procedure via a limited incision for Sprengel deformity: a retrospective study on efficacy and
Peng Zhang1, Lianbin Su2, Zijie Sun1
1Department of Orthopedics, The 904th Hospital of Joint Logistic Support Force of PLA, Wuxi, China.
Background:
The Woodward procedure is a standard surgical treatment for Sprengel deformity (SD), but its classic execution requires extensive tissue dissection. This study aimed to evaluate the outcomes of a Modified Woodward Procedure via a Limited Incision (MWP-LI), designed to minimize tissue trauma while enhancing functional and cosmetic results.
Methods:
We retrospectively reviewed eight consecutive SD patients (5 Cavendish grade III, 3 grade II) treated with the MWP-LI between January 2022 and December 2023. The key modifications included a short midline incision, creation of a limited trapezius-rhomboid musculofascial flap, dynamic integrated release under continuous scapular traction, and selective scapulothoracic release. Tension-reducing cosmetic closure was employed.
Results:
At a mean follow-up of 26.5 months, the mean active shoulder abduction improved significantly by 58.0° (from 96.5° ± 11.8° to 154.5° ± 10.6°, p < 0.001). The mean Cavendish grade improved by 1.8 grades. We recognize that this follow-up duration is insufficient to assess long-term growth-related recurrence; ongoing follow-up is planned. All parents reported high satisfaction with the outcomes. No instances of scapular winging, neurovascular injury, or other major complications were observed.
Conclusion:
The MWP-LI offers a reliable, less invasive, and cosmetically superior alternative for correcting SD.
Level Of Evidence:
Therapeutic Level IV.