Sprengel's deformity is a rare congenital anomaly, with scapula malposition. We present a unique subgroup of Sprengel's possessing a cleithrum, an ancestral remnant of shoulder-girdle development found in bony-fish. This challenges management providing valuable insight into scapular embryology and development. Sprengel's deformity is a rare congenital anomaly of the shoulder girdle characterised by scapula malposition, associated with atrophy of periscapular muscles causing disfigurement and limited shoulder movement. Traditionally, it has been managed by omovertebral bar excision and muscle transplantation procedures guided by age and Cavendish grading. We present a unique, previously undescribed observation in humans: a case series of patients with Sprengel's deformity possessing a cleithrum, an ancestral remnant of shoulder-girdle development found in archaic bony fish.Summary Statement
Introduction
