Abstract
Objective To explore the functional and cosmetic outcomes of Sprengel deformity after Woodward procedure and partial scapulectomy and employ three-dimensional-computed tomography (3D-CT) technique for evaluating the morphometric characteristics of Sprengel deformity. Methods From September 2011 to September 2016, 29 patients (15 boys and 14 girls) with Sprengel deformity underwent Woodward procedure (n=19), clavicle osteotomy (n=4) and partial scapulectomy (n=10). The average operative age was (3.69±1.34) years. A Philips 64-row machine was employed with Philips Intellispace Portal software for reconstructing bone tissue and shielding soft tissues. And an Ebm dicom viewer was employed for assessing the values of height-to-width ratio, superior displacement ratio, rotational difference and anterior curvature of supraspinous portion. The functional and cosmetic outcomes were evaluated on the basis of changes in shoulder abduction and the radiographic findings using Cavendish classification. Results During a postoperative follow-up period of (46.38±18.05) months, significant improvement of at least 1 Cavendish grade was documented in all cases except for one child. The postoperative shoulder abduction significantly improved [(94.14±9.83) to (154.46±16.97) degrees, P=0]. On preoperative 3D-CT, the mean height-to-width ratio of affected scapula was significantly smaller than that of contralateral counterpart. An inverse relationship existed between rotational difference and superior displacement ratio. One patient was associated with Klippel-Feil syndrome. There were spinous processes (n=4), partial spinal fusion (n=4), partial rib fusion (n=2), scoliosis (n=1), omovertebral bone (n=22) and anterior curvature of supraspinous portion (n=12). Conclusions 3D-CT is helpful in evaluating pathological anatomy of Sprengel deformity. Both Woodward procedure and partial scapulectomy offer satisfactory cosmetic and functional outcomes. Key words: Congenital abnormalities; High scapula; Operation
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