Modified combined Woodward and Green procedure for adult congenital Sprengel deformity.

Abstract

ObjectiveTo investigate the clinical efficacy and incidence of complications in the treatment of adult congenital high scapula (Sprengel deformity) using the modified combined Woodward and Green surgical approach.MethodsFrom January 2020 to January 2024, 9 adult patients with congenital Sprengel deformity were treated with the modified Woodward and Green combined procedure. There were two males and seven females, aged 18-35 years (mean: 23.5 ± 4.2 years), with 6 cases on the left and 3 on the right. The surgical procedure involved the modified combined Woodward and Green technique. Postoperatively, routine infection prevention, 4-weeks brace fixation, and rehabilitation guidance were performed. Shoulder appearance was evaluated using the Cavendish grading system; bilateral scapular height difference was measured; and shoulder function was assessed using the UCLA Shoulder Function Rating System, including pain, daily activity ability, range of motion, and muscle strength. Paired t-tests were used to analyze pre- and postoperative data with SPSS 22.0 software.ResultsAll 9 patients were followed up for 12-36 months (mean: 24.11 ± 6.63 months). Postoperatively, shoulder appearance significantly improved, with marked reduction in scapular position, good correction of elevation and shrugging deformities, and near-normal shoulder contour. Cavendish grading improved significantly (<i>p</i> < 0.05). The scapular height difference decreased from 4.50 ± 0.67 cm preoperatively to 0.89 ± 0.77 cm at the last follow-up, and the UCLA shoulder function score increased from 23.44 ± 1.57 to 30.33 ± 0.67, with statistically significant differences (<i>p</i> < 0.001 for both).ConclusionThe modified combined Woodward and Green procedure is a safe and effective treatment for adult congenital Sprengel deformity, significantly improving shoulder appearance and joint function. However, due to the small sample size and short follow-up period, future studies with larger samples and longer follow-ups are needed to accurately evaluate the long-term efficacy.