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Surgical management of Sprengel’s deformity by a modification of Green’s procedure

A single center experience
  • Yu JiangEmail author
  • Yuan Guo
  • Zhenghua Zhu
  • Yukun Wang
Originalien
  • 18 Downloads

Abstract

Background

Sprengel’s deformity is a rare congenital anomaly that can present in children, leading to cosmetic and functional impairment. This study investigated clinical results of this deformity among cases managed using a modified Green procedure.

Methods

From February 2008 to September 2015 a total of 34 patients with Sprengel’s deformity were treated with a modified Green procedure. The mean age of patients at the time of surgery was 4.8 years (range 2–12 years) and the average follow-up time was 6.1 years (range 4–10 years). The shoulder abduction, Cavendish classification, Rigault classification, scapular elevation, and postoperative complications were evaluated.

Results

The mean shoulder abduction was 102.3° (range 70–140°) preoperatively and 142.6° (range 120–170°) postoperatively. The scapular elevation was 4.2 cm (range 2–6.5 cm) preoperatively and 1.35 cm (range 0–2 cm) postoperatively. Improvement by at least one Cavendish and/or Rigault grade was attained in all cases postoperatively. The differences in preoperative and postoperative shoulder abduction, scapular elevation, Cavendish grade and Rigault grade were statistically significant (p < 0.001).

Conclusion

The modified Green procedure is a relatively safe and reliable method in the treatment of severe Sprengel’s deformity, which ensures successful shoulder function as well as a good cosmetic appearance.

Keywords

Surgical techniques Congenital elevation of the scapula Musculoskeletal abnormality Retrospective study Pediatrics 

Operatives Management einer Sprengel-Deformität mittels modifizierter Green-Technik

Eine Singlecenter-Erfahrung

Zusammenfassung

Hintergrund

Bei der Sprengel-Deformität handelt es sich um eine seltene kongenitale Anomalie, die bei Kindern auftreten kann und zu kosmetischen und funktionellen Beeinträchtigungen führt. In dieser Studie wurden die klinischen Ergebnisse dieser Deformität bei Fällen, die mit einer modifizierten Green-Technik behandelt wurden, untersucht.

Methoden

Von Februar 2008 bis September 2015 wurden insgesamt 34 Patienten mit Sprengel-Deformität mittels der modifizierten Technik nach Green behandelt. Das mittlere Alter der Patienten zur Zeit der Operation war 4,8 Jahre (Range: 2–12 Jahre), und die durchschnittliche Follow-up-Zeit betrug 6,1 Jahre (Range: 4–10 Jahre). Die Schulterabduktion, Cavendish-Klassifikation, Rigault-Klassifikation, skapuläre Elevation sowie postoperative Komplikationen wurden bewertet.

Ergebnisse

Die mittlere Schulterabduktion betrug 102,3° (Range: 70–140°) präoperativ und 142,6° (Range: 120–170°) postoperativ. Die skapuläre Elevation lag bei 4,2 cm (Range: 2–6,5 cm) präoperativ und 1,35 cm (Range: 0–2 cm) postoperativ. Eine Verbesserung von mindestens einem Grad nach Cavendish und/oder Rigault wurde postoperativ in allen Fällen erreicht. Die Unterschiede in der präoperativen und postoperativen Schulterabduktion, skapulären Elevation, Cavendish- und Rigault-Grad waren statistisch signifikant (p < 0.001).

Schlussfolgerung

Die modifizierte Green-Technik ist ein relativ sicheres und zuverlässiges Verfahren in der Behandlung einer schweren Sprengel-Deformität, das sowohl eine gute Schulterfunktion sowie ein gutes kosmetisches Ergebnis ermöglicht.

Schlüsselwörter

Operationstechnik Kongenitale Elevation der Skapula Muskuloskeletale Abnormalitäten Retrospektive Studie Pädiatrie 

Notes

Compliance with ethical guidelines

Conflict of interest

Y. Jiang, Y. Guo, Z. Zhu and Y. Wang declare that they have no competing interests.

All procedures performed in studies involving human participants or on human tissue were in accordance with the ethical standards of the institutional and/or national research committee and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study. For images or other information within the manuscript which identify patients, consent was obtained from them and/or their legal guardians.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  1. 1.Department of pediatric orthopedicsBeijing Jishuitan Hospital, the Fourth Medical College of Peking UniversityBeijingChina

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