{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T06:36:06Z","timestamp":1777358166628,"version":"3.51.4"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Sprengel deformity is a rare congenital anomaly of the shoulder that leads to cosmetic and functional impairment. This study aimed to evaluate the clinical efficacy of the Woodward procedure in children, with a focus on both functional and cosmetic outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on 13 pediatric patients with unilateral Sprengel deformity who underwent the Woodward procedure. The average follow-up was 3.9 years (range,1\u201312 years). Preoperative and postoperative assessments were performed using the Cavendish grading and Rigault classification systems. Shoulder abduction angles were measured, and associated anomalies were documented. Intraoperative \u201cwake-up\u201d test was performed to confirm brachial plexus integrity for severe cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mean preoperative shoulder abduction was 114.2\u00b0. Postoperatively, significant improvements were observed in both cosmetic and functional outcomes. According to the Cavendish classification, 92.3% of patients achieved an excellent cosmetic result (grade 1). The Rigault classification showed 92.3% of patients improved to grade 1. The mean improvement was 2.1 grades for Cavendish and 1.5 grades for Rigault. For superior displacement, the mean value decreased substantially from 32.68\u2005mm preoperatively to 11.33\u2005mm postoperatively. Similarly, the mean rotational angle was reduced from 23.35\u00b0 to 6.43\u00b0 after surgery. Partial regeneration of the superior scapular angle was identified in two cases, with a residual omovertebral bone present in one. Complications were minimal, with no brachial plexus injuries or reoperations reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The Woodward procedure proves to be a safe and effective surgical intervention for Sprengel deformity, providing significant and sustained improvements in both cosmetic appearance and shoulder function in pediatric patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1751083","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T05:39:13Z","timestamp":1777354753000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical efficacy analysis of Woodward's procedure for Sprengel deformity in children"],"prefix":"10.3389","volume":"14","author":[{"given":"Tao","family":"Li","sequence":"first","affiliation":[{"name":"Pediatric Orthopedics Department, Northwest Women\u2019s and Children\u2019s Hospital","place":["Xi'an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wusheng","family":"Miao","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedics Department, The Third Affiliated Hospital of Xi'an Medical University","place":["Xi'an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yinghan","family":"Lei","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedics Department, Northwest Women\u2019s and Children\u2019s Hospital","place":["Xi'an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hai","family":"Jiang","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedics Department, Northwest Women\u2019s and Children\u2019s Hospital","place":["Xi'an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1097\/BPO.0b013e318288b407","article-title":"Sprengel deformity: morphometric assessment and surgical treatment by the modified green procedure","volume":"34","author":"Wada","year":"2014","journal-title":"J Pediatr Orthop"},{"key":"B2","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1007\/s00132-019-03818-2","article-title":"Surgical management of Sprengel's deformity by a modification of Green's procedure: a single center experience","volume":"49","author":"Jiang","year":"2020","journal-title":"Orthopade"},{"key":"B3","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1097\/01202412-199907000-00010","article-title":"Results of surgical treatment of Sprengel deformity by a modified Green's 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Am"},{"key":"B10","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1302\/0301-620X.54B3.395","article-title":"Congenital elevation of the scapula","volume":"54","author":"Cavendish","year":"1972","journal-title":"J Bone Joint Surg Br"},{"key":"B11","doi-asserted-by":"publisher","first-page":"E1150","DOI":"10.1097\/BRS.0000000000003523","article-title":"Sprengel deformity: comprehensive evaluation of concomitant spinal and extraspinal anomalies in 90 patients","volume":"45","author":"\u00d6ner","year":"2020","journal-title":"Spine"},{"key":"B12","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1097\/01.bpb.0000049568.52224.1e","article-title":"Sprengel\u2019s deformity: long-term follow-up study of 22 cases","volume":"12","author":"Farsetti","year":"2003","journal-title":"J Pediatr Orthop B"},{"key":"B13","doi-asserted-by":"publisher","first-page":"e405","DOI":"10.1016\/j.jse.2021.12.040","article-title":"Utilization of intraoperative neuromonitoring during the Woodward procedure for treatment of Sprengel deformity","volume":"31","author":"Feng","year":"2022","journal-title":"J Shoulder Elbow Surg"},{"key":"B14","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1097\/BPB.0000000000001206","article-title":"Is the use of neuromonitoring necessary in Sprengel's deformity surgery?","volume":"34","author":"Akar","year":"2025","journal-title":"J Pediatr Orthop B"},{"key":"B15","doi-asserted-by":"publisher","first-page":"e19797","DOI":"10.7759\/cureus.19797","article-title":"Outcomes of Woodward's procedure for Sprengel's shoulder using neurophysiological monitoring of the brachial plexus without clavicular osteotomy: a retrospective study","volume":"13","author":"Bin Majid","year":"2021","journal-title":"Cureus"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1541132","DOI":"10.3389\/fped.2025.1541132","article-title":"Woodward procedure with intraoperative neuromonitoring for Sprengel deformity: a retrospective study with a mean 5-year follow-up","volume":"13","author":"Zhang","year":"2025","journal-title":"Front Pediatr"},{"key":"B17","doi-asserted-by":"publisher","first-page":"2653","DOI":"10.1007\/s00264-020-04850-0","article-title":"Functional improvement in patients with Sprengel's deformity following modified Green's procedure and simplified clavicle osteotomy-a study of forty cases","volume":"44","author":"Naik","year":"2020","journal-title":"Int Orthop"},{"key":"B18","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1007\/s11832-010-0265-7","article-title":"Long-term results of modified Green method in Sprengel's deformity","volume":"4","author":"Gonen","year":"2010","journal-title":"J Child Orthop"},{"key":"B19","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1097\/BPO.0b013e3181e4f5a6","article-title":"Surgical correction of severe Sprengel deformity to allow greater postoperative range of shoulder abduction","volume":"30","author":"Ahmad","year":"2010","journal-title":"J Pediatr Orthop"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1751083\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T05:39:14Z","timestamp":1777354754000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1751083\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,28]]},"references-count":19,"alternative-id":["10.3389\/fped.2026.1751083"],"URL":"https:\/\/doi.org\/10.3389\/fped.2026.1751083","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,28]]},"article-number":"1751083"}}