ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Orthopedics
Volume 13 - 2025 | doi: 10.3389/fped.2025.1541132
Woodward procedure with intraoperative neuromonitoring for Sprengel deformity, A retrospective study with mean of 5-Year follow-up
Provisionally accepted
- 1University Hospital Bonn, Bonn, Germany
- 2Department of Orthopedics, Shanghai Children's Medical Center, Shanghai, Shanghai Municipality, China
- 3Department of Neurology, Shanghai Children's Medical Center, Shanghai, China
- 4Department of Pediatrics, Shenyang Children's Hospital, Shenyang, Liaoning Province, China
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The Woodward procedure was designed to correct Sprengel deformity (SD) while brachial plexus injury remains a critical complication. This study aimed to assess the effectiveness of the Woodward procedure with clavicle osteotomy and intraoperative neuromonitoring (IONM) in enhancing postoperative functional outcomes, cosmetic appearance, and nerve injury prevention.We retrospectively reviewed the records of patients who underwent the Woodward procedure with clavicle osteotomy and IONM for Sprengel deformity at our institution between January 2013 and May 2023. Patient demographics, clinical and cosmetic outcomes before and after surgery, and complications were analyzed.Results: A total of 36 patients (female: male=16:20) with a mean age of 4.1 ± 1.5 years were included, with a mean follow-up of 5.6 years. Intraoperatively, no IONM alerts occurred. At the latest follow-up, shoulder abduction improved by an average of 74°, and Cavendish grade improved from grade 3 or 4 preoperatively to grade 1 or 2. Radiographic analysis showed Rigault grade improvement from grade 3 to grade 1 or 2. Aside from a single instance of delayed wound healing and one case of hypertrophic scarring, no brachial plexus injuries or long-term complications were observed.Conclusions: Woodward procedure combined with clavicle osteotomy and IONM for SD patients is associated with significant improvement in postoperative functional outcome, cosmetic appearance, low risk of complications and high levels of satisfaction.
Keywords: Sprengel deformity, intraoperative neuromonitoring, clavicle osteotomy, brachial plexus injury, Somatosensory evoked potentials, Motor evoked Potentials
Received: 07 Dec 2024; Accepted: 28 May 2025.
Copyright: © 2025 Zhang, CAI, Huang, Yang, Huang, Miao, Cai and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhigang Wang, Department of Orthopedics, Shanghai Children's Medical Center, Shanghai, 200000, Shanghai Municipality, China
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