Long-term follow-up of Sprengel's deformity treated with the Woodward procedure

Walstra, Frances E.; Alta, T.D.W.; Eijken, Jan-Willem van der; Willems, W. Jaap; Ham, S.J.

doi:10.1016/j.jse.2012.08.014

Cited by 29 publications

(30 citation statements)

References 23 publications

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“…Gain in abduction (median 40 , P < .001) after the modified Woodward procedure in our series is comparable with those seen in other reports with short-to medium-term follow-up (Table V). 5,11,13,15 Particular note is made of long-term results reported by Walstra et al 24 and Gonen et al, 13 which showed that improvement in abduction is maintained at 14.7 and 11.3 years after surgery, respectively. Collectively, these results suggest that surgery may considerably alter the natural history of shoulder range of motion in Sprengel's deformity.…”

Section: Discussionmentioning

confidence: 98%

“…For example, the natural history of shoulder range of motion in the untreated patient is not known. 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.…”

mentioning

confidence: 99%

“…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.…”

mentioning

confidence: 99%

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

Vuillermin

Wang

Williams

et al. 2021

Journal of Shoulder and Elbow Surgery

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Background: Sprengel's deformity is a congenital anomaly of the scapula and can be associated with reduced shoulder mobility and esthetic concerns. Controversies remain regarding its natural history, radiographic findings, and optimal treatment strategy. Methods: A total of 74 Sprengel's shoulders in 71 patients presenting to a pediatric referral hospital were retrospectively reviewed including 24 surgically treated shoulders. Median age at initial presentation was 3.8 years. Median age at the final follow-up was 9.6 years. Results: Twenty shoulders were analyzed for range of motion across time. The median composite abduction range was initially 105 and at the last time-point 98 , with a median loss of 15 over 5 years (P ¼ .007). A total of 26% of the nonsurgical shoulders reported pain at the latest follow-up, compared with 1 surgical patient (4%) (P ¼ .028). Older age was independently associated with pain (P < .001); this effect was only seen in nonsurgical patients. Radiographically, the glenoid inclination angle (GIA) independently correlated with the abduction range (P ¼ .001). Surgically treated shoulders underwent a modified Woodward procedure at a median 4.8 years of age. At a median follow-up of 41 months, the abduction range improved in the surgical group from 90 preoperatively to 110 postoperatively, with a median gain of 40 (P < .001). The median GIA changed from À2 to 4 with a median gain of 9 (P ¼ .004). Conclusions: The natural history of untreated Sprengel's deformity may be one of gradual decline in the abduction range, with a proportion of patients developing pain in adolescence. The GIA correlates with the shoulder abduction range. Surgery with a modified Woodward procedure may alter the natural history of the condition by improving motion and reducing risk of pain later in life.

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Section: Discussionmentioning

confidence: 98%

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confidence: 99%

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confidence: 99%

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

Vuillermin

Wang

Williams

et al. 2021

Journal of Shoulder and Elbow Surgery

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“…The Green procedure achieved improvement in the range of abduction by 49°-57°on average [3]. Walstra et al [16] reported that the range was improved by 41°at 1 year postoperatively and by 56°at the final visit (mean follow-up period: 14.7 years). The outcomes achieved at our departments were improvement by 49°after ∼9 years of follow-up, which, in addition to the improvement rate, was comparable with those reported previously.…”

Section: Discussionmentioning

confidence: 99%

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

Nakamura

Inaba

Machida

et al. 2016

Journal of Pediatric Orthopaedics B

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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.

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“…La cirugía está indicada en los grados 3 y 4 con limitación de movimientos de hombro. 5,6 Los resultados son satisfactorios en 80% de los casos y malos cuando existen malformaciones asociadas en la columna vertebral. 7,8…”

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