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Erschienen in: International Orthopaedics 12/2020

23.10.2020 | Original Paper

Functional improvement in patients with Sprengel’s deformity following Modified Green’s procedure and simplified clavicle osteotomy—a study of forty cases

verfasst von: Premal Naik, Hitesh Chauhan

Erschienen in: International Orthopaedics | Ausgabe 12/2020

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Abstract

Purpose

Sprengel’s deformity though rare is the most common congenital anomaly of the shoulder region. The aim of the study was to check the effectiveness of the modified Green’s procedure with simplified clavicle osteotomy in providing significant functional and radiological improvement without neurovascular complications.

Methods

Sixty-eight children of Sprengel deformity were operated by the modified Green’s release. Of which forty patients (15 male, 25 female) with more than two years follow-up were evaluated retrospectively. Simplified clavicle osteotomy was done in 34 patients. Severity was graded clinically by Cavendish grading (Grade II—6, III—34) and radiologically by Rigault grading (Grade II – 35, III - 5). The average age at surgery was 5.05 years with a mean follow-up of 62 (24–145) months.

Results

The average improvement in Cavendish grade was 2.6 grades, and Rigault grading was 1.07 grades. Shoulder abduction improved by a mean of 360. There was no neurovascular complication in children who had simplified clavicle osteotomy, and one patient without clavicle osteotomy developed transient brachial plexus palsy. Other complications were wound gape, pleural tear and scapular winging.

Conclusion

The modified Green’s procedure with simplified clavicle osteotomy allows for excellent correction of function and cosmesis. We describe a simpler technique of clavicle osteotomy that is quick, safe and equally effective in preventing neurovascular complications. We also describe a surrogate clinical test to avoid potential neurological injury in the absence of neuromonitoring. To the best of our knowledge, this is the second-largest operative series of Sprengel’s deformity.
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Metadaten
Titel
Functional improvement in patients with Sprengel’s deformity following Modified Green’s procedure and simplified clavicle osteotomy—a study of forty cases
verfasst von
Premal Naik
Hitesh Chauhan
Publikationsdatum
23.10.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 12/2020
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-020-04850-0

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