Partial scapulectomy for sprengel shoulder using Greitemann, Rondhuis, and Karbowski technique

Abstract

Introduction Sprengels shoulder is a rare congenital deformity resulting from failure of the scapula to descend properly. In most of the cases superomedial scapula is connected to the spinous processes, laminae, or transverse processes by a fibrous tissue, cartilage, or bone called the omovertebral connection. Treatment depends upon the severity of the deformity. The main objectives of surgery are to improve the cosmetic appearance and to improve the scapular function. Case history A case of 7 year old male child with left sprengel shoulder presented with only a cosmetic problem. On examination patient having full range of left shoulder movements ,no associated congenital                anomalies, with Rigualt grade 2 and Cavendish grade 2.Hence we proceeded with omovertebral bar excision and resection of superomedial border of scapula as described by Greitemann, Rondhuis, and Karbowski technique. Discussion Patients with mild deformity do not require operative intervention. However, in patients with more severe disease,(cavendish III,IV and Rigault 2,3) surgery is considered as first line treatment. The basic surgical technique is to first release the cause of the scapular binding (omovertebral bar) and secondly to relocate the scapula ( distalization of scapula). Indication for operative treatment should be very strict. It seems reasonable to do only a resection of the superior angle of the scapula and omovertebral bone excision, if there is only cosmetic problems and no functional deficits.conclusion Indication for operative treatment should be very strict. It seems reasonable to do only a resection of the superior angle of the scapula and omovertebral bone excision, if there are only cosmetic problems and no functional deficits. We got good cosmetic improvement           following resection of superomedial portion of scapula and omovertebral bar excision as suggested by Greitemann , Rondhuis, and Karbowski.