title: Sprengel's shoulder treated by the Woodward procedure: analysis of factors affecting functional and cosmetic outcome.
abstract: OBJECTIVE
  To report the functional and cosmetic results of cases with Sprengel's shoulder who underwent the Woodward procedure.
  
  
  METHODS
  Twelve children were operated at a mean age of 5.58 years and reviewed at an average follow up of 31.83 months.
  
  
  RESULTS
  The mean preoperative Cavendish grade for cosmetic evaluation was 3.17, which decreased to 1.25 postoperatively (statistically significant, p < 0.0005, Wilcoxon signed-rank test). Similarly, the range of abduction at the shoulder increased from a mean of 115.83° preoperatively to 153.33° at final review (p < 0.0005). Age had a negative correlation with both functional improvement (r = -0.55, Spearman correlation coefficient) and cosmetic improvement (r = -0.11), although the latter suggested a very weak association, if any. Cavendish grade improvement and increase in abduction had a strong positive association (r = 0.713). However, there was no correlation between the increase in abduction and lowering of the scapula achieved (r = 0.131). The presence of an omovertebral bar did not affect the final functional outcome, nor did the presence of associated congenital anomalies.
  
  
  CONCLUSIONS
  The Woodward procedure is a reliable method for obtaining uniformly predictable results in Sprengel's shoulder. The surgery should be performed at a younger age in order to optimise the functional outcome.
authors.affiliation: Department of Orthopaedics, Government Medical College Hospital, Chandigarh, India.
authors.forename: Nipun
authors.initials: N
authors.lastname: Jindal
authors.forename: Parmanand
authors.initials: P
authors.lastname: Gupta
keywords: Congenital; Scapula; Sprengel’s shoulder; Woodward procedure
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