Sprengel’s deformity is an uncommon congenital difference that is difficult to treat. Multiple procedures have proposed with complications mainly due to recurrence of the deformity and minimal functional improvement. In 2001, Mears introduced a new technique based on scapular osteotomy with partial resection of the scapula and release of the long head of the triceps. The goal of the present study is for the authors to present their results. Over a 5 year period, 20 patients with Sprengel’s deformity were evaluated. Fourteen patients underwent surgery based on clinical deformity and lack of motion. All of them underwent the Mears technique, which again consists of scapular osteotomy, partial resection of the scapula and release of the long head of the triceps. The article contains diagrams and figures regarding the procedure. Range of motion and patient satisfaction were used as outcome measures.
The mean age of surgery was about 7 years. There were some associated pathologies including scoliosis, Klippel-Feil syndrome, clubfoot, and syndactyly. All cases had at least 1 year of follow-up, with a mean follow-up of almost 4 years. Seventy-eight percent of the cases had an omovertebral bone that connected the superomedial border of the scapula with cervical vertebrae. This was resected to the time of the procedure. Results showed that range of motion significantly improved from preoperative flexion of 84° to postoperative flexion of 152°. Abduction also improved from 81 to 145°. No weakness was detected about the shoulder girdle. No cases of neurologic injury occurred.
Sprengel’s deformity is very difficult to treat and surgery has variable results. There have been numerous techniques described that are reviewed in the article. Most of the techniques have focused on the descent of the scapula and trying to relocate the scapula in a better position. The Mears technique involves excision of the superomedial angle of the scapula and an oblique osteotomy through the body of the scapula to avoid impingement during range of motion. The authors report amazing results with marked improvement in appearance and motion. Certainly, this is a technique worth considering when surgery of Sprengel’s deformity is indicated.