Surgical Treatments for the Congenital Dysplasia of the Scapula.

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This study reports the outcomes of surgical treatments for congenital elevation and hypoplasia of the scapula.6 shoulders of 5 patients with congenital elevation (1 Sprengel's deformity, 1 Noonan syndrome bilateral, 3 Klippel-Feil syndrome) and 1 patient with congenital hypoplasia of the scapula were treated surgically. They were followed-up for 2 months to 17 years 3 months (average: 7 years 4 months). There were 2 males and 4 females and their ages ranged from 3 to 15 years (average: 6 years 5 months).For the congenital elevation of the scapula, the König method was carried on 3 shoulders (in 1 case, Z-plasty was added for the webbed neck), and the Woodward method on 1 shoulder. The patient with the Noonan syndrome was operated on by osteotomy with release in 2 shoulders. In this bilateral case, for the weakness of the shoulder abductor, pectoralis major muscle transfer was added during reoperation. The congenital hypoplasia was treated with pectoralis major muscle transfer only.The range of motion of the shoulder and downward displacement of the inferior angle of the scapula were investigated in these patients.The average shoulder abduction angle improved from 99.2° to 140° at the final follow-up. The average downward displacement of the scapula was 6.2mm (-11mm to 26mm). Patients with Sprengel's deformity showed better results functionally and cosmetically compared to those with underlying diseases such as Klippel-Feil and Noonan syndrome. Patients with muscle hypoplasia around the shoulder girdle were treated with pectoralis major muscle transfer, and satisfactory functional improvement was observed, From these results, good results may be obtained for shoulder girdle muscle hypoplasia by pectoralis major muscle transfer to improve scapular abduction.

Surgical Treatments for the Congenital Dysplasia of the Scapula.

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