Patient-Reported Outcomes in Children Undergoing the Modified Green Procedure for Treating Sprengel’s Deformity: Results from a Multicentric Study

Background: Sprengel’s Deformity (SD) is a rare condition of the shoulder girdle, appearing as the principal congenital anomaly of the shoulder in paediatric patients. The aim of this study is to document the combined experience of two paediatric orthopaedic departments in managing SD using the modi...

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Main Authors: Giovanni Trisolino, Paola Zarantonello, Marco Todisco, Giovanni Luigi Di Gennaro, Grazia Chiara Menozzi, Philipp Scheider, Alessandro Depaoli, Diego Antonioli, Gino Rocca, Sebastian Farr
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Children
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Online Access:https://www.mdpi.com/2227-9067/12/1/18
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author Giovanni Trisolino
Paola Zarantonello
Marco Todisco
Giovanni Luigi Di Gennaro
Grazia Chiara Menozzi
Philipp Scheider
Alessandro Depaoli
Diego Antonioli
Gino Rocca
Sebastian Farr
author_facet Giovanni Trisolino
Paola Zarantonello
Marco Todisco
Giovanni Luigi Di Gennaro
Grazia Chiara Menozzi
Philipp Scheider
Alessandro Depaoli
Diego Antonioli
Gino Rocca
Sebastian Farr
author_sort Giovanni Trisolino
collection DOAJ
description Background: Sprengel’s Deformity (SD) is a rare condition of the shoulder girdle, appearing as the principal congenital anomaly of the shoulder in paediatric patients. The aim of this study is to document the combined experience of two paediatric orthopaedic departments in managing SD using the modified Green Procedure, with a specific emphasis on the clinical and functional outcomes reported by patients; Methods: from June 2010 to February 2023, 42 shoulders in 40 paediatric patients were surgically treated for SD at two paediatric orthopaedic departments. All patients were treated using the modified Green Procedure with or without clavicle osteotomy. To better evaluate the deformity, the Cavendish’s classification for aesthetic appearance and the Rigault’s classification for radiological aspect were used, while movements of abduction and flexion were quantified to assess shoulder mobility. Several dedicated questionnaires such as QuickDASH, the Shoulder Pain Index and the Shoulder Disability Index (SPADI) and finally the UCLA Shoulder Scale were submitted to assess the quality of life of the subjects and the ability to practice certain activities, including work and sports. Complications were evaluated according to the modified Clavien–Dindo–Sink classification; Results: The mean follow-up was 5 years (range, 1.0–13.6). Clavicular osteotomy, performed in 15 patients, improved post-operative abduction by a mean of 25° (95% CI: 11–39°; <i>p</i> = 0.001). Three patients had complications (7.1%), with two requiring re-operation. At follow-up, 67.5% of patients had a qDASH score < 7, highlighting excellent functional outcomes. Shoulder function showed moderate correlation with pre- and post-operative flexion. The SPADI and UCLASS scores indicated significant improvement, with 70.0% reporting high satisfaction. Factors like sex, associated anomalies, and surgical technique did not impact patient-reported outcomes or satisfaction; Conclusions: The modified Green’s technique has proven to be a safe procedure with a low rate of complications and satisfactory clinical and functional patient-reported outcomes.
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spelling doaj-art-2e75c32808994234a9cdc422d46ab2822025-01-24T13:27:00ZengMDPI AGChildren2227-90672024-12-011211810.3390/children12010018Patient-Reported Outcomes in Children Undergoing the Modified Green Procedure for Treating Sprengel’s Deformity: Results from a Multicentric StudyGiovanni Trisolino0Paola Zarantonello1Marco Todisco2Giovanni Luigi Di Gennaro3Grazia Chiara Menozzi4Philipp Scheider5Alessandro Depaoli6Diego Antonioli7Gino Rocca8Sebastian Farr9Pediatric Orthopedics and Traumatology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, ItalyOrthopedics and Traumatology Unit, IRCCS Istituto Ortopedico Rizzoli, 44011 Argenta, ItalyPediatric Orthopedics and Traumatology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, ItalyPediatric Orthopedics and Traumatology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, ItalyPediatric Orthopedics and Traumatology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, ItalyDepartment of Pediatric Orthopaedics and Adult Foot and Ankle Surgery, Orthopedic Hospital Speising, 1130 Vienna, AustriaOrthopedics and Traumatology Unit, IRCCS Istituto Ortopedico Bagheria, 90011 Bagheria, ItalyPediatric Orthopedics and Traumatology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, ItalyPediatric Orthopedics and Traumatology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, ItalyDepartment of Pediatric Orthopaedics and Adult Foot and Ankle Surgery, Orthopedic Hospital Speising, 1130 Vienna, AustriaBackground: Sprengel’s Deformity (SD) is a rare condition of the shoulder girdle, appearing as the principal congenital anomaly of the shoulder in paediatric patients. The aim of this study is to document the combined experience of two paediatric orthopaedic departments in managing SD using the modified Green Procedure, with a specific emphasis on the clinical and functional outcomes reported by patients; Methods: from June 2010 to February 2023, 42 shoulders in 40 paediatric patients were surgically treated for SD at two paediatric orthopaedic departments. All patients were treated using the modified Green Procedure with or without clavicle osteotomy. To better evaluate the deformity, the Cavendish’s classification for aesthetic appearance and the Rigault’s classification for radiological aspect were used, while movements of abduction and flexion were quantified to assess shoulder mobility. Several dedicated questionnaires such as QuickDASH, the Shoulder Pain Index and the Shoulder Disability Index (SPADI) and finally the UCLA Shoulder Scale were submitted to assess the quality of life of the subjects and the ability to practice certain activities, including work and sports. Complications were evaluated according to the modified Clavien–Dindo–Sink classification; Results: The mean follow-up was 5 years (range, 1.0–13.6). Clavicular osteotomy, performed in 15 patients, improved post-operative abduction by a mean of 25° (95% CI: 11–39°; <i>p</i> = 0.001). Three patients had complications (7.1%), with two requiring re-operation. At follow-up, 67.5% of patients had a qDASH score < 7, highlighting excellent functional outcomes. Shoulder function showed moderate correlation with pre- and post-operative flexion. The SPADI and UCLASS scores indicated significant improvement, with 70.0% reporting high satisfaction. Factors like sex, associated anomalies, and surgical technique did not impact patient-reported outcomes or satisfaction; Conclusions: The modified Green’s technique has proven to be a safe procedure with a low rate of complications and satisfactory clinical and functional patient-reported outcomes.https://www.mdpi.com/2227-9067/12/1/18SprengelSprengel’s deformityshoulderGreen procedureGreen’s technique
spellingShingle Giovanni Trisolino
Paola Zarantonello
Marco Todisco
Giovanni Luigi Di Gennaro
Grazia Chiara Menozzi
Philipp Scheider
Alessandro Depaoli
Diego Antonioli
Gino Rocca
Sebastian Farr
Patient-Reported Outcomes in Children Undergoing the Modified Green Procedure for Treating Sprengel’s Deformity: Results from a Multicentric Study
Children
Sprengel
Sprengel’s deformity
shoulder
Green procedure
Green’s technique
title Patient-Reported Outcomes in Children Undergoing the Modified Green Procedure for Treating Sprengel’s Deformity: Results from a Multicentric Study
title_full Patient-Reported Outcomes in Children Undergoing the Modified Green Procedure for Treating Sprengel’s Deformity: Results from a Multicentric Study
title_fullStr Patient-Reported Outcomes in Children Undergoing the Modified Green Procedure for Treating Sprengel’s Deformity: Results from a Multicentric Study
title_full_unstemmed Patient-Reported Outcomes in Children Undergoing the Modified Green Procedure for Treating Sprengel’s Deformity: Results from a Multicentric Study
title_short Patient-Reported Outcomes in Children Undergoing the Modified Green Procedure for Treating Sprengel’s Deformity: Results from a Multicentric Study
title_sort patient reported outcomes in children undergoing the modified green procedure for treating sprengel s deformity results from a multicentric study
topic Sprengel
Sprengel’s deformity
shoulder
Green procedure
Green’s technique
url https://www.mdpi.com/2227-9067/12/1/18
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