Introduction: Sprengel deformity is also named High Congenital Scapula (HCS).

It is a rare abnormality in children of which consequences are cosmetic and functional too.

Purpose: It is to assess those anatomic findings which have a prognostic value and to focus on the main stages of the treatment.

Material and Methods: We reviewed a series of 23 cases of HCS in 19 children, 4 of whom having had a bilateral involvement. In all the cases, the elevation of the scapula was accompanied by a rotation and a varus position of the glena.

The age of our patients ranged from 6 months to 13 years old. 50% of them were younger than 9 at the first visit. Functional consequences consisted in a modification of the plan of the movements of shoulder. Besides the omovertebral bone, many important abnormalities – mainly of the spine – have been noticed in our series.

The cases were classified using the degree of elevation of the superomedial angle of scapula. Three grades could be set up.

Concerning the treatment, 2 children have not been operated on. In the other cases, we used a modification of the Woodward procedure.

Results: Two cases were judged to have a poor result. One case had a fair result.

79% were considered as good on both aspects, cosmetically and functionally, with no complication.

The age at which surgery has been performed seems to have no influence on the result. On the opposite, the number and the severity of the anatomic anomalies have to be taken into consideration for the prognostic assessment.

Discussion: As comparing our results with those of the other series, we could notice that our procedure is less aggressive. Indeed, the majority of the surgical procedures mention a resection of a part of the scapula. In such a way, the cosmetic result can be easily improved, even if the scapula has not been really lowered. On the other hand, the anti-varus stage of our procedure improves the plan of movements of the shoulder.

Conclusion: The Sprengel deformity could need surgical correction in the moderate and major deformities. Surgery shall lower the scapula as much as possible, but it shall avoid neurologic or vascular complications. At last, surgery is first indicated for improving the biomechanics of the scapular girdle.

Purpose: In order to improve our understanding of club-foot, an international rating system of evaluation is proposed which is supported by the International Club Foot Study Group (ICFSG).

Method: All the parameters of the assessment shall be objective. They are clinical and radiographic. On the clinical side, the morphology of foot is assessed for the hindfoot, midfoot and the forefoot. Then, the global morphology of the foot and lower limb is assessed. But the function of the foot is the major criteria which enhances the value of the outcome. It is assessed on the passive motion of the different parts of the foot. Then, the active motion is evaluated. Arc added a clinical gait analysis and the occurrence of eventual pain. On the radiographic side, the various angles of bones axes are calculated on AP and lateral views.

Results: The score of Outcome Evaluation ranges from 0 up to 60 points, the latter expressing the worst result. Four groups of results are mentioned so as excellent, good, fair and poor. The Outcome Evaluation should be performed at 6 years old and at the end of the growth.

Conclusion: The Outcome Evaluation will allow us to be able to compare truly the forthcoming series of club-foot.