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Correction in Malrotation of the Scapula and Muscle Transfer for the Management of Severe Sprengel Deformity: Static and Dynamic Evaluation Using 3-Dimensional Computed Tomography

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Title: Correction in Malrotation of the Scapula and Muscle Transfer for the Management of Severe Sprengel Deformity: Static and Dynamic Evaluation Using 3-Dimensional Computed Tomography
Authors: Yamada, Katsuhisa Browse this author
Suenaga, Naoki Browse this author
Iwasaki, Norimasa Browse this author →KAKEN DB
Oizumi, Naomi Browse this author
Minami, Akio Browse this author →KAKEN DB
Funakoshi, Tadanao Browse this author →KAKEN DB
Keywords: Sprengel deformity
muscle transfer
Issue Date: Mar-2013
Publisher: Lippincott Williams & Wilkins
Journal Title: Journal of Pediatric Orthopaedics
Volume: 33
Issue: 2
Start Page: 205
End Page: 211
Publisher DOI: 10.1097/BPO.0b013e318279c656
PMID: 23389577
Abstract: Background: The clinical results of surgical procedures for severe Sprengel's deformity have been uncertain. To obtain improved elevation, we consider that it is necessary to realign the lateral border of the scapula for upward rotation. The purposes of the current study were to evaluate the clinical results and range of motion of the scapula after such realignment. Methods: Seven cases of Sprengel's deformity of Cavendish grade 3 or 4 were treated surgically and then clinically evaluated and examined using three-dimensional computed tomography (3D CT). (Two boys and five girls aged 50.9 ± 15.4 months, mean ± standard deviation at the time of operation.) The mean follow-up was 53.1 months (range, 12 to 92 months). After the omovertebral bone and the superomedial side of the scapula were removed, the levator scapulae and rhomboids were reattached to wrap around the scapula at maximum upward rotation to assist in maintaining this position. Cavendish and Rigault grades were used for evaluation of postoperative appearance. The superior displacement and rotation of the scapula were measured on the trunk posterior view using 3D CT. The relationship between improvement in the range of motion and radiologic change were analyzed statistically. Results: The postoperative flexion (97.9° ± 12.9° to 160° ± 11.5°) and abduction (99.3° ± 13.0° to 161.4° ± 15.7°) were significantly improved compared with the mean preoperative values (P < .0001). 3D CT revealed that in all patients the malrotation of the scapula was improved postoperatively. The current study shows that successful realignment of the scapula led to these improved clinical results. Conclusions: Our procedure has advantages not only for recovery of the range of motion but also for reducing the characteristic lump in the web of the neck. However, our procedure has an inherent limitation related to asymmetrical shoulder level and width. 3D CT may be useful for preoperative planning and postoperative evaluation.
Rights: This is a non-final version of an article published in final form in Journal of Pediatric Orthopaedics, March 2013, 33(2), pp.205-211
Type: article (author version)
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 船越 忠直

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