Subperiosteal resection of mid-clavicle in Sprengel\'s deformity correction

Abstract

We report the results of fifteen cases of Sprengel’s deformity treated surgically by initial subperiosteal resection of the middle third of the clavicle in conjunction with surgical release of all attachments of the scapula to the spine, excision of any omovertebral bone and resection of prominent supraspinous process of scapula. The patients included ten female and three male patients (age range at the time of operation, 3.3–10 years; mean: 6.11 years). The deformity involved the left shoulder in eight patients, the right shoulder in three and two were bilateral. All patients were followed for an average of 5.9 years (range 4–11 years). Preoperatively, the arc of total abduction (glenohumeral and scapulothoracic) ranged from 80 to 140°, and the average was 110°. The shoulders were level, and the range of motion was dramatically improved with an average range of abduction of 166.5° (range 140–180°). The age of the patients and the presence of an omovertebral bone did not influence the results. All patients and their parents expressed satisfaction with the operative results. We feel that our procedure is a simple one, which helps to improve the degree of correction, avoid neurovascular complications and has the advantage of complete regeneration of the clavicle. The technique provides an easy, safe method of repositioning the scapula at its normal level.

Use of glenoid inclination angle for the assessment of unilateral congenital high scapula

“…Moreover, no patients have suffered from brachial plexus palsy. Some authors reported that the combination of the Woodward and clavicular morcellization procedures contributes toward an improved ROM [14]. Even compared with other procedures, we consider that this combination can achieve similar treatment outcomes [3,5,10,15] and is a treatment method that can be performed safely.…”

Surgical Treatment of Sprengel’s Deformity: A Systematic Review and Meta-Analysis

“…Most studies reported the patients’ sex, except three [ 34 , 43 , 57 ], and the affected side, except eight [ 21 , 23 , 43 , 47 , 50 , 54 , 57 , 59 ]. In the preoperative evaluation, 28 studies classified patients according to the Cavendish clinical scoring system [ 2 , 9 , 14 , 16 , 17 , 19 , 20 , 21 , 23 , 33 , 35 , 36 , 37 , 38 , 41 , 42 , 44 , 45 , 46 , 47 , 48 , 49 , 52 , 53 , 55 , 58 , 59 , 60 ] and 15 studies [ 14 , 15 , 16 , 17 , 19 , 21 , 32 , 36 , 41 , 45 , 48 , 53 , 57 ,…”

“…Twenty-three studies (441 patients) reported the grade of deformity, according to the Cavendish classification [ 9 , 14 , 16 , 17 , 19 , 20 , 21 , 23 , 35 , 36 , 37 , 41 , 42 , 44 , 45 , 46 , 48 , 52 , 53 , 55 , 58 , 59 , 60 ]. Ninety-seven patients (22%) were grade 4, 283 patients (64.2%) were grade 3, 51 patients (11.5%) were grade 2 and 10 patients (2.3%) were grade 1.…”

“…The Putti–Schrock procedure was reported only by Farsetti [ 32 ] and Sulamaa [ 13 ] in nine cases. The original and modified Green procedure was reported in 14 papers [ 14 , 15 , 23 , 34 , 35 , 37 , 39 , 40 , 44 , 45 , 47 , 48 , 51 , 53 ], accounting for 280 patients; Woodward’s procedure (or modified techniques) was performed in 18 studies [ 2 , 9 , 16 , 17 , 23 , 32 , 33 , 42 , 43 , 46 , 49 , 50 , 54 , 55 , 56 , 57 , 58 , 60 ], accounting for 234 patients. Bhasker [ 41 ], Masquijo [ 19 ] and Mears [ 18 ] treated 29 patients overall with Mears’s technique.…”

“…Twenty-three studies (383 patients) reported the postoperative Cavendish grade [ 2 , 9 , 14 , 16 , 17 , 19 , 20 , 21 , 33 , 35 , 36 , 37 , 41 , 42 , 44 , 45 , 46 , 48 , 52 , 55 , 58 , 59 , 60 ]. Of them, 16 studies (236 patients) [ 14 , 17 , 19 , 20 , 21 , 35 , 36 , 37 , 41 , 44 , 46 , 52 , 55 , 58 , 59 , 60 ] reported preoperative and postoperative raw data. Fourteen studies (219 patients) reported the postoperative Rigault classification [ 14 , 15 , 16 , 17 , 19 , 21 , 32 , 36 , 41 , 45 , 48 , 57 , 58 …”