Treatment of congenital elevation of the scapula: 10 (2–18) year follow-up of 37 cases of Sprengel's deformity

Greitemann, Bernhard; Rondhuis, J.; Karbowski, A.

doi:10.3109/17453679308993646

Cited by 34 publications

(33 citation statements)

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“…In terms of keloid formation risk and postoperative scarring, better results were reported using the Woodward method than Green [4]. However, a rate of up to 60% of unsightly scar formation using the Woodward technique was reported in some series [16], while this was observed in 22.2% of shoulders with the modified Green technique in the present study.…”

Section: Discussioncontrasting

confidence: 59%

“…Nevertheless, the number of scapuloplasty (transplantation) cases in these studies was very small. The remaining literature on Sprengel deformity consists of small numbers of cases ranging between 2 and 21 patients with a mean followup of 2 to 12 years, with most being short-medium term [2,3,5,7,8,[12][13][14][15][16][18][19][20][21][22][23][24][25] and rarely long term [4,26,27]. Moreover, the results are presented according to different means of evaluation, such as patient satisfaction, cosmetic appearance alone, function, or Rigault's radiologic classification, and they involve various types of surgery in a small number of patients, which also makes comparisons difficult.…”

Section: Discussionmentioning

confidence: 99%

“…The modification of the Green method by Ehrlich as described in an article by Leibovic et al [10] was performed in 24 patients (16 female, 8 male) for surgical treatment. Clavicular osteotomy was also performed in supine position just before scapular transposition in all cases as suggested [4,5,15] and omovertebral bone excision in 13 shoulders. In order to perform the osteotomy carefully, neurovascular structures beneath the clavicle were protected by an ''S'' retractor during the procedure.…”

Section: Methodsmentioning

confidence: 99%

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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: Discussioncontrasting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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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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“…Dendane et al (25) enfatizam que os candidatos ideais a cirurgias de reposicionamento da escápula são aqueles com menos de quatro anos de idade, enquanto Greitemann et al (26) consideram que o ideal seria a operação abaixo dos seis anos. Khairouni et al (27) afirmam que tanto a idade do paciente quanto a presença do osso omovertebral não influenciam os resultados.…”

Section: Discussionunclassified

Deformidade de Sprengel: tratamento cirúrgico pela técnica de green modificada

Reginaldo¹,

Macedo²,

Amaral³

et al. 2009

Rev. bras. ortop.

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RESUMOObjetivo: Demonstrar os resultados estéticos e funcionais de pacientes submetidos à correção cirúrgica de escápula alta congênita -deformidade de Sprengel -por uma modificação da técnica de Green, bem como avaliar o grau de satisfação dos pacientes e as complicações da técnica utilizada. Métodos: Foram avaliados nove pacientes operados pela técnica de Green modificada, no período de setembro de 1993 a abril de 2008. Como modificação da técnica original foram realizados descolamento muscular subperiosteal, ressecção apenas da porção súpero-medial da escápula e, em vez da utilização de tração esquelética, optou-se pela fixação com fio de aço subcutâneo da porção medial da espinha da escápula à crista ilíaca posterior contralateral. A idade média dos pacientes foi de sete anos e três meses. O seguimento pós-operatório médio foi de três anos e sete meses. Resultados: Houve incremento médio na elevação de cerca de 39 o (variando de 0 o a 80 o ). Segundo a classificação de Cavendish, obteve-se a melhora estética de dois graus em oito casos e de três graus em um. Todos os pacientes ficaram satisfeitos com o resultado. Conclusões: Os pacientes com deformidade de Sprengel submetidos a tratamento cirúrgico por meio de uma modificação da técnica de Green, com fixação da escápula na crista ilíaca posterior contralateral em vez de se utilizar tração esquelética, apresentaram melhora tanto funcional como estética; todos os pacientes e/ou familiares ficaram satisfeitos e as complicações relacionadas com a técnica cirúrgica não interferiram no resultado final. Descritores

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“…8, 18 The optimal age is controversial but most authors agree that surgery has best results when performed between 3 and 8 years. 19 Corrective operations range from simple excision of the superior angle of the scapula 8,20 (associated with very high recurrence rates) to subtotal scapulectomy 9,21 (associated with poor functional outcome). Contemporary surgical procedures are based on one of three operations and their modifications:…”

Section: Managementmentioning

confidence: 99%