Woodward procedure improves shoulder function in Sprengel deformity.

Abstract

Background: Sprengel deformity is a congenital failure of descent of the scapula. Limited shoulder abduction and cosmetic appearance are the major concerns. Although the Woodward procedure reportedly affords satisfactory correction, the long-term functional outcome postoperatively has not been addressed.

Methods: Eight patients (9 shoulders) who underwent the Woodward procedure for Sprengel deformity were evaluated. The cosmetic appearance and functional results of the shoulders were evaluated using the Cavendish grading system and functional Constant scoring. Grading of the cosmetic appearance, range of motion of the shoulder, and radiographs were obtained for interpretation.

Results: After a mean follow-up of 113 ± 29 months, the cosmetic appearance had improved. The Cavendish cosmetic grade improved significantly (p = 0.000). The superior displacement ratio decreased from 0.5 ± 0.1 to 0.2 ± 0.1 (p = 0.004). The height-to-width ratio of the affected scapula increased from 1.3 ± 0.2 (range 1.1 to 1.7) to 1.6 ± 0.2 (range 1.4 to 2.0) (p = 0.001). The abduction of the shoulder improved from 122 ± 14 (range 100 to 140) degrees to 157 ± 20 (range 125 to 180) degrees (p = 0.008). The average abduction power of the involved shoulders was 21.8 ± 3.2 lbs, which was not significantly different from the uninvolved shoulders 23.1 ± 2.5 lb (p = 0.525). The average Constant score for the operated shoulders was 91.7 ± 4.2 (range 82 to 96) points.

Conclusion: The Woodward procedure offers substantial improvement of shoulder function and cosmetic appearance for patients.