Woodward Procedure Improves Shoulder Function in Sprengel Deformity

Background: Sprengel deformity is a congenital failure of descent of the scapula. Limitedshoulde r abduc t ion and cosme t i c appe a r anc e a r e the ma jor conc e rns .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 forSprengel deformity were evaluated. The cosmetic appearance and functionalresults of the shoulders were evaluated using the Cavendish grading systemand functional Constant scoring. Grading of the cosmetic appearance, rangeof motion of the shoulder, and radiographs were obtained for interpretation.Results: After a mean follow-up of 113 29 months, the cosmetic appearance hadimproved. 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). Theabduction of the shoulder improved from 122 14 (range 100 to 140)degrees to 157 20 (range 125 to 180) degrees (p = 0.008). The averageabduction power of the involved shoulders was 21.8 3.2 lbs, which wasnot 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.