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SPRENGEL’S DEFORMITY. 3-D CT ANALYSIS OF THE MORPHOLOGY IN RELATION TO SURGICAL DECISION-MAKING



Abstract

Aim: Assessment of unilateral Sprengel’s deformity using CT scan with 3-D reconstruction in order to determine if there are sub-groups in which different procedures maybe appropriate.

Materials and Methods: Between 1996 and 2002, 14 consecutive patients with unilateral Sprengel’s deformity were assessed using CT scanning with 3-D reconstruction. Size, shape, elevation and rotation of the scapulae and glenoid were measured. The incidence of omovertebral connections and congenital abnormalities were noted. A spiral CT scanner was used.

Results: 3 of the 14 cases had clearly abnormal scapulae with widespread and multiple associated abnormalities. These were classified as the dysplastic group. The other 11 cases had wide variation in the elevation of the scapula or glenoid, the length of the supra-spinous portion and the rotation of the scapula and glenoid. There was only one case of a superior hook. The location of the tether could be determined from the shape of the medial border. It was noted that rotation was variable and elevation was variable.

Conclusion: It was felt that no one procedure was appropriate for all scapulae, but the guiding factors included the elevation of the glenoid, the rotation of the glenoid, the location of the tether in addition to the clinical considerations. It was felt that these features were best evaluated using this 3-D CT scanning technique.

The abstracts were prepared by the Editorial Secretary Robin W Paton. Correspondence should be addressed to him c/o BOA, 35–43 Lincoln’s Inn Field, London WC2A 3PN.