title: Long-term follow-up of Sprengel's deformity treated with the Woodward procedure.
abstract: BACKGROUND
  Sprengel's deformity is a congenital anomaly of the shoulder with superior displacement and rotation of the hypoplastic scapula. The functional impairment and misshapen appearance of the shoulder can be minimized with different surgical techniques. The aim of this study was to evaluate the long-term results after correction of Sprengel's deformity using the Woodward procedure.
  
  
  METHODS
  In this retrospective study, 8 shoulders were examined at 3 different periods in time. The average follow-up was 14.7 years (range, 8-26). Range of motion, Constant score, DASH (Disabilities of the Arm, Shoulder and Hand) score, and simple shoulder test (SST) were obtained to evaluate shoulder function. Scapula placement and degenerative disease were assessed by radiographic examination and the Rigault's classification. Cavendish grading was used to evaluate cosmetic appearance.
  
  
  RESULTS
  Mean age at the time of surgery had been 8 years and 9 months. Mean follow-up was 13.5 years. Abduction improved by 41° in the first year after surgery, with final improvement of 56° at long-term follow-up. At the latest follow-up evaluation, the mean Constant score was 85 points, the DASH score 14.59 points, and the SST 9.5 points. Radiographs showed superior displacement of the involved scapula in all cases, with no signs of degenerative disease of the shoulder. Cavendish grade improved from grade 3 preoperatively to grade 1 or 2 at the latest follow-up examination. No long-term complications had occurred.
  
  
  CONCLUSIONS
  The Woodward procedure shows to be an effective surgical procedure to improve shoulder function as well as cosmetic appearance in patients with Sprengel's deformity.
authors.affiliation: Department of Orthopedic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors.forename: Frances E
authors.initials: FE
authors.lastname: Walstra
authors.forename: Tjarco D
authors.initials: TD
authors.lastname: Alta
authors.forename: Jan-Willem
authors.initials: JW
authors.lastname: van der Eijken
authors.forename: W Jaap
authors.initials: WJ
authors.lastname: Willems
authors.forename: S John
authors.initials: SJ
authors.lastname: Ham
mesh_terms: D002648:Child; D002675:Child, Preschool; D002968:Clavicle / Q000601:surgery; D000013:Congenital Abnormalities / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D010027:Osteotomy; D017060:Patient Satisfaction; D011859:Radiography; D012189:Retrospective Studies; D012540:Scapula / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D012785:Shoulder Joint / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome