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

Abstract

Little has been reported on the motion of the scapula in Sprengel's deformity. Fourteen patients with unilateral congenital high scapula underwent the Woodward procedure from 1986 to 2004. The median age of the patients at the time of surgery was 4.4 years and the median follow-up duration was 8.8 years. The range of motion of the shoulder and the glenoid inclination angle (GIA) were measured preoperatively and at the final visit. The range of motion of the shoulder and GIA improved at the final visit. There was a positive correlation between the maximum abduction angle of the upper limb and GIA at the final visit.

Sprengel's deformity: an analysis of surgically and nonsurgically treated patients

“…The exception to this is the GIA (Fig. 1), which was initially described by Nakamura et al 20 In a series of 14 shoulders, the authors found a moderate positive correlation between the GIA and shoulder abduction range. Our results based on 58 shoulders appear to corroborate this finding, albeit with a slightly weaker correlation (r ¼ 0.41, Fig.…”

“…Numerous radiographic markers have been described for Sprengel's deformity. 1,7,19,20,23,28 In almost all cases, the radiographic markers were used to compare scapular position change from before and after surgery, but had not been correlated with shoulder function or clinical relevance. The exception to this is the GIA (Fig.…”

“…Rigault type I is defined as the superomedial pole of the scapula below the transverse process of T2, type II as the superomedial pole lying between transverse processes of C5 and T2, and type III as the superomedial pole of the scapula above the transverse process of C5. 21 In addition, the glenoid inclination angle (GIA), 20 superior scapular angle, 19 inferior scapular angle, 19 glenoid rotation angle, 7 and scapular spine angle were measured for each shoulder. 28 The scapular height-to-width ratio was not measured, as the medial border of the scapula is frequently not identifiable on plain radiographs.…”

“…28 The scapular height-to-width ratio was not measured, as the medial border of the scapula is frequently not identifiable on plain radiographs. Vertical distances between scapulae were also not recorded, 20,28 as these tended to vary significantly with the age of the patient and magnification of radiographs.…”

“…Although most patients presenting in early childhood do not complain of pain, 11,24 it is unclear if this remains true into adolescence and adulthood. There is wide variation in operative criteria and techniques between different authors and centers, 1,2,11,13,20,22,24 with most reports using the Cavendish classification, 6 a largely qualitative classification assessed with the patient fully clothed and not accounting for range of motion, as an indicator for surgery. Although many radiological measurements for Sprengel's shoulders have also been described, 1,7,19,20,23,28 their relevance is unclear as it is not known how well they correlate with clinical function or natural history.…”