Woodward procedure with intraoperative neuromonitoring for Sprengel deformity: a retrospective study with a mean 5-year follow-up.

IF 2 3区医学 Q2 PEDIATRICS

Frontiers in Pediatrics Pub Date : 2025-06-27 eCollection Date: 2025-01-01 DOI:10.3389/fped.2025.1541132

Li Zhang, Haoqi Cai, Yangbo Huang, Mengting Yang, Shi Huang, Mingyuan Miao, Haiqing Cai, Zhigang Wang

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引用次数: 0

Abstract

Background: 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.

Methods: 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.

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Woodward手术术中神经监测治疗Sprengel畸形：一项平均5年随访的回顾性研究。

背景：Woodward手术被设计用于纠正Sprengel畸形（SD），而臂丛损伤仍然是一个重要的并发症。本研究旨在评估Woodward手术联合锁骨截骨术和术中神经监测（IONM）在提高术后功能预后、美容外观和预防神经损伤方面的有效性。方法：我们回顾性回顾2013年1月至2023年5月在我院接受Woodward手术锁骨截骨和IONM治疗Sprengel畸形的患者记录。分析患者的人口统计学特征、手术前后的临床和美容结果以及并发症。结果：共纳入36例患者（女：男= 16:20），平均年龄4.1±1.5岁，平均随访5.6年。术中未发生IONM警报。在最近的随访中，肩关节外展平均改善了74°，Cavendish评分从术前的3级或4级提高到1级或2级。放射学分析显示Rigault评分从3级提高到1或2级。除了一例伤口延迟愈合和一例增生性瘢痕外，没有观察到臂丛损伤或长期并发症。结论：Woodward手术联合锁骨截骨联合IONM治疗SD患者在术后功能预后、美观、并发症风险低、满意度高等方面均有显著改善。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Pediatrics Medicine-Pediatrics, Perinatology and Child Health

CiteScore

3.60

自引率

7.70%

发文量

2132

审稿时长

14 weeks

期刊介绍： Frontiers in Pediatrics (Impact Factor 2.33) publishes rigorously peer-reviewed research broadly across the field, from basic to clinical research that meets ongoing challenges in pediatric patient care and child health. Field Chief Editors Arjan Te Pas at Leiden University and Michael L. Moritz at the Children''s Hospital of Pittsburgh are supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. Frontiers in Pediatrics also features Research Topics, Frontiers special theme-focused issues managed by Guest Associate Editors, addressing important areas in pediatrics. In this fashion, Frontiers serves as an outlet to publish the broadest aspects of pediatrics in both basic and clinical research, including high-quality reviews, case reports, editorials and commentaries related to all aspects of pediatrics.