Abstract
In this outcome-based study, we reviewed the results of the modified Woodward procedure performed on 10 patients over the last 15 years in our unit. The indication for surgery was a unilateral Sprengel’s deformity, Cavendish grade II or III, in children aged 3 to 6 years. Follow-up times ranged from 1 to 15 years. The patients were assessed according to patient and relatives’ satisfaction, cosmesis and functional results.
The modified Woodward procedure entailed a midline longitudinal incision over the spinous processes from C1 to T8. The origins of the trapezius and rhomboids were released from the spinous processes, the scapula lowered and derotated, the superomedial portion of the scapula resected and the trapezius and rhomboids reattached two vertebral levels lower. The clavicle was not osteotomised in any patient. A Velpeau sling was used for four weeks, after which physiotherapy was started.
There were no brachial plexus complications. There were two cases of winging of the scapulae. One patient had a cosmetically ugly scar. Our results showed a cosmetic improvement by an average of one grade and a mean functional improvement of 30° of abduction and flexion. Those patients where an omovertebral body was found and resected had the best cosmetic and functional results. All the patients were satisfied with their operations.
We feel that the pessimism regarding surgical results is unwarranted.
The abstracts were prepared by Professor M. B. E. Sweet. Correspondence should be addressed to him at The Department of Orthopaedic Surgery, Medical School, University of Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193 South Africa
