Sprengelʼs Deformity Associated with Multidirectional Shoulder Instability

Hamner, Dyson L.; Hall, John E.

doi:10.1097/01241398-199509000-00018

Cited by 13 publications

(5 citation statements)

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“…Because of scapulothoracic stiffness and an inferiorly rotated glenoid, abduction of the shoulder is limited [8]. It may also be associated with multidirectional shoulder instability [9]. Although no improvement or worsening is reported in untreated grade I and II patients, surgery is recommended in Cavendish III and IV deformity when the superomedial angle of the scapula is above C6 [7].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Results of Modified Green Method in Sprengel's Deformity

Gönen

Şimşek

Solak

et al. 2010

Journal of Children's Orthopaedics

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Aim Congenital undescended scapula (Sprengel deformity) is a rare deformity that is reported in the literature mostly as small case series with short-or medium-term follow-up periods. Here, we aimed to present the long-term results of this deformity treated with modified Green procedure. Method The modified Green procedure was performed in 24 patients (28 shoulders) with Sprengel deformity. Clavicular osteotomy accompanied in all, and omovertebral bone excision in 13 shoulders. The mean age of the patients at the time of surgery was 4.5 years (range 1.5-17 years). Mean follow-up period was 11 years 4 months (4.3-17 years). Preoperative cosmetic appearance was noted as Cavendish III in 17 shoulders and as IV in 11 shoulders. In addition to the Cavendish scale, shoulder abduction, shoulder asymmetry, and scapular elevation and medialization were evaluated. ResultsThe decrease in scapular elevation and Cavendish scale, and the improvement in shoulder abduction and scapular medialization postoperatively were statistically significant (P \ 0.001). Cosmetic improvement of at least one Cavendish grade were attained in 88.9% of shoulders. One patient (unilateral) who was Cavendish grade IV preoperatively died in the early postoperative period from unrelated causes. Of the remaining 10 preoperatively grade IV shoulders, 2 remained at the same grade, 1 improved to grade III, and 7 shoulders to grade I. Of the 17 preoperatively grade III shoulders, 1 shoulder stayed the at same grade, 7 shoulders improved to II, and 9 shoulders to grade I. Postoperative winging in 2 shoulders and hypertrophic scarring in 6 shoulders were noted. Conclusion The modified Green procedure is a relatively safe and reliable method in the treatment of severe Sprengel deformity cases and provides highly constructive and aesthetic results in the long term.

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Section: Introductionmentioning

confidence: 99%

Long-Term Results of Modified Green Method in Sprengel's Deformity

Gönen

Şimşek

Solak

et al. 2010

Journal of Children's Orthopaedics

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“…It is caused by a variable arrest in the descent of the scapula during intrauterine development 12. Sprengel’s deformity was first described by Eulenberg, in 1863, as, ‘hochgradige dislocation der scapula’ (i.e., a high-grade dislocation of the scapula),3 but it was Sprengel in 1891, who illustrated this deformity in four cases, and hence its name 4 –6. In 1883, Willet and Walsham were the first to describe the omovertebral bone and the methods of its excision 7.…”

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confidence: 99%

“…Depending on the severity, the deformity could be obvious at birth or manifest later in childhood. Occasionally Sprengel’s deformity could also occur as part of the Klippel Feil Syndrome (in 30% cases)248 or could be associated with other spinal and cranial anomalies28 or absent ribs 9. Several treatment options and techniques were described in literature that mainly focussed on positioning the scapula at its normal anatomical location 61011.…”

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Outcome of Mears procedure for Sprengel’s deformity

Bhasker¹,

Khullar

Habeeb

2011

IJOO

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Background:Sprengel’s shoulder is characterized by scapular maldescent and malposition, causing restriction of shoulder and cervical spine movements. It is associated with a variety of other congenital anomalies. Various surgical procedures have been described to treat this anomaly with no consensus as to the surgical procedure of choice. We report the results of the Mears procedure in the treatment of Sprengel’s shoulder.Materials and Methods:Seven children between the age group of two and six years were treated for Sprengel’s deformity, with omovertebral bar, and other congenital anomalies. The Cavendish score and Rigault radiological score were used to assess the severity of the deformity, and the position of the scapula relative to the cervical spine, respectively. The Mears procedure involved scapular osteotomy, par tial scapular excision, and release of a long head of triceps. Clavicular osteotomy was done only in two cases to decrease the risk of traction injury to the brachial plexus. Postoperatively, the patients were immobilized in a shoulder sling and range of motion exercises were started as early as possible. The patients were followed regularly at six weeks, three months and regularly at six-months interval.Results:The mean improvement in flexion and abduction was 45 ° (40 – 70 °) and 50 ° (40 – 70 °), respectively, which was the combined glenohumeral and thoracoscapular movement. The cosmetic and functional improvement by this procedure was acceptable to the patients. Minor scar hypertrophy was seen in two cases.Conclusion:The Mears procedure gives excellent cosmetic and functional results. This procedure addresses the functional aspect of the deformity and is much more acceptable to the patient and parents.

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“…The characteristics of Sprengel deformity are an undescended scapula (being unilateral or may even be bilateral), a small and deformed scapula, medial rotation of the inferior pole of the scapula that causes the glenoid to face inferiorly, and the presence of an omovertebral bone in 25-30% of cases (Grogan et al, 1983;Hamner and Hall, 1995).…”

Section: Discussionmentioning

confidence: 98%