Results of surgical treatment for Sprengle's deformity with vertical corrective scapular osteotomy.

Mohammad Amin Aslani,Amir Farahanchi Baradaran,Majid Eyvaz Ziaei,Hamidreza Aslani,Fateme Mirzaee,Zohreh Zafarani

doi:10.1016/j.amsu.2020.03.006

Abstract

IntroductionSprengle deformity is the most common congential anomaly of shoulder complex that is the result of scapular placement in cephalad abnormal position. The purpose of this study is the evaluation of clinical and radiological results of vertical corrective scapular osteotomy and comparision of these results with previous studies.MethodsWe retrospectively reviewed the results of the vertical corrective scapular osteotomy (VSO) with or without clavicular osteotomy and wake-up test in 31 consecutive patients at an average duration of follow up of 30 month (6 month-15 years). 22 patients were girls and 9 were boys. The average age of the patients was 7.3 years (3-13) at the time of surgery. We evaluated the clinical and radiological results of this method in last fallow-up. No funding was used for this study and there are no conflicts of interest.Results31 surgical procedures were performed. All osteotomies were healed. No neurovascular complication. Postoperative the mean shoulder flexion and abduction were improved 30 and 36° respectively (p < 0.001). The mean improvement of superior scapular angle (S.S.A) and inferior scapular angle (I.S.A) were 16 and 21° respectively (p < 0.001).ConclusionIt is intuitive that more cosmetic scapular lowering with little chance of neurovascular problems can be achieved after VSO. In addition, scapular rotation can be corrected using this technique, which should be considered as one of the advantages of this technique.We believe that a properly applied VSO procedure in severe deformities is safe with predictable outcomes in the treatment of a complex deformity that provides favorable functional and cosmetic outcomes in the longer term.

Highlights

Sprengle deformity is the most common congential anomaly of shoulder complex that is the result of scapular placement in cephalad abnormal position
Sprengel shoulder or congenital elevation of the scapula is associated with abnormal descending and altered position as well as the anatomy of the scapula [1,2,3,4] [Fig. 1]
The deformity was in the left shoulder in 9 and right in 18 patients, while 4 had bilateral deformity

Summary

Introduction

Sprengle deformity is the most common congential anomaly of shoulder complex that is the result of scapular placement in cephalad abnormal position. Methods: We retrospectively reviewed the results of the vertical corrective scapular osteotomy (VSO) with or without clavicular osteotomy and wake-up test in 31 consecutive patients at an average duration of follow up of 30 month (6 month-15 years). Sprengel shoulder or congenital elevation of the scapula is associated with abnormal descending and altered position as well as the anatomy of the scapula [1,2,3,4] [Fig. 1]. Vertical scapular osteotomy (VSO) is considered a relocation procedure that can provide both cosmetic and functional improvement [9,10]. This technique was first described by Konig in 1914, which was popularized by Wilkinson and Campbell [11]. The choice of surgery is still based on surgeon's preference [2,12,13]

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