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Sprengel's shoulder treated by the Woodward procedure: analysis of factors affecting functional and cosmetic outcome.
J Child Orthop. 2012 Aug;6(4):291-6
Authors: Jindal N, Gupta P
Abstract
PURPOSE: To report the functional and cosmetic results of cases with Sprengel's shoulder who underwent the Woodward procedure.
MATERIALS AND METHODS: Twelve children were operated at a mean age of 5.58 years and reviewed at an average follow up of 31.83 months.
RESULTS: The mean preoperative Cavendish grade for cosmetic evaluation was 3.17, which decreased to 1.25 postoperatively (statistically significant, p < 0.0005, Wilcoxon signed-rank test). Similarly, the range of abduction at the shoulder increased from a mean of 115.83° preoperatively to 153.33° at final review (p < 0.0005). Age had a negative correlation with both functional improvement (r = -0.55, Spearman correlation coefficient) and cosmetic improvement (r = -0.11), although the latter suggested a very weak association, if any. Cavendish grade improvement and increase in abduction had a strong positive association (r = 0.713). However, there was no correlation between the increase in abduction and lowering of the scapula achieved (r = 0.131). The presence of an omovertebral bar did not affect the final functional outcome, nor did the presence of associated congenital anomalies.
CONCLUSION: The Woodward procedure is a reliable method for obtaining uniformly predictable results in Sprengel's shoulder. The surgery should be performed at a younger age in order to optimise the functional outcome.
PMID: 23904895 [PubMed]
Read more... http://www.ncbi.nlm.nih.gov/pubmed/23904895?dopt=Abstract
