BACKGROUND: Sprengel deformity is a rare congenital malformation of the scapula. To date, there have been limited reports analyzing the clinical outcomes of the modified Woodward procedure and conservative management in the treatment of Sprengel deformity. This study aims to further investigate the clinical efficacy of these 2 treatment strategies.
METHODS: A retrospective analysis was conducted on 28 patients (30 shoulders) with Sprengel deformity treated at our institution between 2013 and 2024, of whom 15 underwent the modified Woodward procedure. Shoulder function, appearance, and scapular position were evaluated using the Cavendish and Rigault classifications, as well as the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire.
RESULTS: In the nonsurgical group, with a mean follow-up of 4.9±2.2 years, no significant change in shoulder abduction angle was observed (P>0.05). In contrast, the surgical group, with a mean follow-up of 8.0±2.8 years, showed significant improvement, with the shoulder abduction angle increasing from 125 degrees preoperatively to 168 degrees at final follow-up (P<0.001). The Cavendish score improved from III to I, and the Rigault grade improved from grade II to III to grade I, all showing significant changes. The QuickDASH score was higher in the surgical group compared with the nonsurgical group.
CONCLUSIONS: The modified Woodward procedure significantly improves shoulder mobility and scapular appearance in patients with Cavendish grade III to IV Sprengel deformity. In contrast, patients with grade I to II deformity generally maintain good function, with no significant progression of the deformity observed during follow-up. Therefore, routine surgical intervention may not be necessary in mild cases.
LEVELS OF EVIDENCE: Level III, case-control study.
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