Clinical Report: Woodward Procedure Effectiveness in Pediatric Sprengel Deformity
Overview
The Woodward procedure significantly improves both cosmetic appearance and shoulder function in pediatric patients with Sprengel deformity. In a retrospective study of 13 children, 92.3% achieved excellent cosmetic results and marked functional gains in shoulder abduction were observed over an average 3.9-year follow-up.
Background
Sprengel deformity is a congenital elevation and dysplasia of the scapula resulting in cosmetic and functional shoulder impairment. It often presents with limited shoulder abduction and may be associated with omovertebral bone and spinal anomalies. Surgical intervention aims to reposition the scapula to improve shoulder function and appearance. The Woodward procedure, involving detachment and caudal relocation of scapular muscles, is widely used to address this condition.
Data Highlights
Parameter
Preoperative Mean
Postoperative Mean
Improvement
Shoulder Abduction (degrees)
114.2°
Not specified exact postop mean but significant improvement noted
Mean shoulder abduction improved significantly from 114.2° preoperatively.
Superior scapular displacement decreased from 32.68 mm to 11.33 mm after surgery.
Rotational deformity of the scapula reduced from 23.35° to 6.43° postoperatively.
Omovertebral bone was present in 46.2% of cases and excised during surgery.
No brachial plexus injuries or reoperations were reported, indicating procedural safety.
Clinical Implications
The Woodward procedure is a reliable surgical option for children with Sprengel deformity, offering substantial improvements in shoulder mobility and cosmetic appearance. The intraoperative wake-up test ensures brachial plexus integrity, enhancing safety. Surgeons should consider this technique especially in cases with severe deformity and associated omovertebral bone.
Conclusion
The Woodward procedure provides safe, effective, and sustained functional and cosmetic improvements in pediatric Sprengel deformity. It remains a preferred surgical approach for managing this complex congenital shoulder anomaly.
References
Woodward 1961 -- Original description of the Woodward procedure
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