Published in:
01-08-2012 | Original Clinical Article
Sprengel’s shoulder treated by the Woodward procedure: analysis of factors affecting functional and cosmetic outcome
Authors:
Nipun Jindal, Parmanand Gupta
Published in:
Journal of Children's Orthopaedics
|
Issue 4/2012
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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.