Aydinli Ufuk, Ozturk Cagatay, Akesen Burak, Ozer Ozgur
Uludag University Medical School, Department of Orthopaedic Surgery, Bursa, Turkey.
Acta Orthop Belg. 2005 Jun;71(3):264-8.
Twelve cases of Sprengel's deformity were treated surgically by a modification of Green's procedure. After clavicular osteotomy, all muscular attachments to the scapula were freed; an omovertebral band if present was cut and the scapula was rotated and moved caudal to a more normal position, to be sutured into a pocket of the latissimus dorsi. The patients included 10 female and 2 male patients (age range at the time of operation: 3 to 9 years; mean: 5.2 years). The deformity involved the left shoulder in 8 patients, the right shoulder in 4. All patients were followed for an average of 2 years (range: 6 months to 4.5 years). The range of flexion improved from an average of 95 degrees to 105 degrees and the range of abduction from an average of 81 degrees to 97 degrees. Cosmesis was improved in all 12 patients but three patients had an unsightly surgical scar. Surgical treatment by a modified Green procedure for patients with Sprengel's deformity is indicated when the patient and family want cosmetic or functional improvement.
采用改良格林手术对12例先天性高肩胛症患者进行了手术治疗。锁骨截骨术后，松解了所有附着于肩胛骨的肌肉；如有肩胛提肌，将其切断，然后将肩胛骨旋转并向下移位至更正常的位置，缝合固定于背阔肌的肌袋内。患者包括10名女性和2名男性（手术时年龄范围：3至9岁；平均年龄：5.2岁）。8例患者畸形累及左肩，4例累及右肩。所有患者平均随访2年（范围：6个月至4.5年）。屈曲范围从平均95度提高到105度，外展范围从平均81度提高到97度。12例患者的外观均有改善，但有3例患者留下了难看的手术瘢痕。当患者及其家属希望改善外观或功能时，可采用改良格林手术对先天性高肩胛症患者进行手术治疗。
