The Sprengel deformity

Abstract

We evaluated scapular dysplasia and malposition in 15 patients with the Sprengel deformity using three-dimensional CT (3D-CT). The shape, height-to-width ratio, the areas of both scapulae, the anterior curvature of the supraspinous portion and glenoid version were assessed on scapular posterior, medial and inferior views. The degree of rotation and superior displacement were measured on the trunk posterior view. The omovertebral connection was also assessed and correlated with the operative findings. Most of the affected scapulae had a characteristic shape with a decrease in the height-to-width ratio and were larger than the contralateral scapulae. There was an inverse relationship between scapular rotation and superior displacement. The typical curve of the supraspinous portion of the scapula was seen in only three cases. There was no significant difference in glenoid version. The point of tethering of the omovertebral connection may determine the shape, rotation and superior displacement of the scapula. 3D-CT was helpful in delineating the deformity in detail, and in planning scapuloplasty.

Passive range of glenohumeral motion in children with a Sprengel’s deformity

“…Mears 12 has claimed that the long head of the triceps contributes to GH adduction restriction; thus, lengthening of this muscle head was added to the scapular osteotomy (Mears procedure). Cho et al, 3 using 3-dimensional computed tomography scans, identified no anomalies in the glenoid version in these children. Ogden et al 13 reported that the acromial end of the clavicle had a greater curvature on the involved side but did not appear to limit shoulder elevation.…”

Sprengel′s deformity of the shoulder: Current perspectives in management

“…Other pathoanatomical findings include an omovertebral bar, articulations with the vertebral column; and these may extend from the superomedial scapular angle or the upper third of the medial border of the scapula up to the transverse process of a cervical vertebra (one of the fourth-to-seventh vertebrae). [124–11] Additionally, costovertebral defects (spina bifida and kyphoscoliosis) and underdevelopment of pectoral girdle bones (clavicle, humerus) and musculature (pectoralis major, trapezius) may coexist. [247]…”

“…Moreover, they found an inverse relationship between scapular rotation and superior displacement [Figures 4–6]. [1]. …”

“…The deformity is usually associated with muscle hypoplasia or atrophy, and a combination of these factors results in disfigurement and functional limitation of the shoulder. [1] The earliest description of this condition was reported in 1863 by Eulenberg; he reported three cases of hochgradige dislocation der scapula and described its association with dorsal scoliosis. Subsequent cases were described in 1880, 1883, and a method of surgical correction was suggested in 1888.…”

Sprengel-Deformität bei einem neunjährigen Jungen: Diagnostik und Therapie

“…Radiologische Verfahren, insbesondere die Computertomographie, erlauben die exakte Darstellung der Morphologie des Schultergürtels. Für diese Indikation sind aufgrund der komplexen Topologie dreidimensionale Oberflächenrekonstruktionen sinnvoll [5]. Die Einteilung des Schweregrades erfolgt nach der von Cavendish vorgeschlagenen vierstufigen Skala [6].…”