A Novel Modification of Woodward Procedure for Correction of Sprengel Deformity by Application of Anchoring Sutures.

Abstract

To report the functional and cosmetic results of cases with Sprengel deformity (SD) who underwent a novel technical modification in Woodward procedure for severe SD comprising of lowering of the scapula followed by stabilization of scapula with application of anchoring sutures. Twenty-three children were operated at a mean age of 6.6 ± 2.5 years (range 3.4-11 years) and followed up for a mean period of 5.51 ± 1.98 years. The mean Cavendish score of the patients before procedure of 3.2 ± 0.45 was reduced to 1.7 ± 0.56 (<i>p</i> < 0.001) after the surgery. All patients improved in global shoulder abduction. The mean preoperative abduction of 97° ± 15.2° increased to a mean of 149° ± 14.1° post-operatively (<i>p</i> < 0.001). Significant improvement was also observed in mean Rigault grades after surgical intervention using anchoring suture modification of Woodward procedure. The mean Rigault grade of 2.7 ± 0.47 prior to surgery was reduced to 1.3 ± 0.47 (<i>p</i> < 0.001) at final evaluation. Age of the patients negatively correlated with the functional outcome (<i>r</i> =  - 0.48; <i>p</i> < 0.02). The presence of an omovertebral bar or associated congenital anomalies did not affect the functional outcome. The modification of Woodward procedure for correction of SD by application of anchoring sutures was a reliable method for correction of SD particularly at younger age. The procedure was associated with significant improvement in shoulder abduction, cosmetic appearance and radiological grades over 5 year follow-up.