{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T07:02:34Z","timestamp":1779951754549,"version":"3.53.1"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"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>Background<\/jats:title>\n                    <jats:p>The Woodward procedure is a standard surgical treatment for Sprengel deformity (SD), but its classic execution requires extensive tissue dissection. This study aimed to evaluate the outcomes of a Modified Woodward Procedure via a Limited Incision (MWP-LI), designed to minimize tissue trauma while enhancing functional and cosmetic results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed eight consecutive SD patients (5 Cavendish grade III, 3 grade II) treated with the MWP-LI between January 2022 and December 2023. The key modifications included a short midline incision, creation of a limited trapezius-rhomboid musculofascial flap, dynamic integrated release under continuous scapular traction, and selective scapulothoracic release. Tension-reducing cosmetic closure was employed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At a mean follow-up of 26.5 months, the mean active shoulder abduction improved significantly by 58.0\u00b0 (from 96.5\u00b0\u2009\u00b1\u200911.8\u00b0 to 154.5\u00b0\u2009\u00b1\u200910.6\u00b0,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). The mean Cavendish grade improved by 1.8 grades. We recognize that this follow-up duration is insufficient to assess long-term growth-related recurrence; ongoing follow-up is planned. All parents reported high satisfaction with the outcomes. No instances of scapular winging, neurovascular injury, or other major complications were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The MWP-LI offers a reliable, less invasive, and cosmetically superior alternative for correcting SD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>Therapeutic Level IV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1760390","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T06:17:24Z","timestamp":1779949044000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The modified woodward procedure via a limited incision for Sprengel deformity: a retrospective study on efficacy and cosmesis"],"prefix":"10.3389","volume":"14","author":[{"given":"Peng","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Orthopedics, The 904th Hospital of Joint Logistic Support Force of PLA","place":["Wuxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianbin","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedics, The First Affiliated Hospital of Xiamen University","place":["Xiamen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zijie","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The 904th Hospital of Joint Logistic Support Force of PLA","place":["Wuxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The 904th Hospital of Joint Logistic Support Force of PLA","place":["Wuxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hengyan","family":"Zhuge","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The 904th Hospital of Joint Logistic Support Force of PLA","place":["Wuxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kefeng","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The 904th Hospital of Joint Logistic Support Force of PLA","place":["Wuxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gengyang","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The 904th Hospital of Joint Logistic Support Force of PLA","place":["Wuxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedics, The First Affiliated Hospital of Xiamen University","place":["Xiamen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"192","DOI":"10.2106\/00004623-199072020-00006","article-title":"Sprengel deformity","volume":"72","author":"Leibovic","year":"1990","journal-title":"J Bone Joint Surg Am"},{"key":"B2","doi-asserted-by":"publisher","first-page":"E1150","DOI":"10.1097\/brs.0000000000003523","article-title":"Sprengel Deformity","volume":"45","author":"\u00d6ner","year":"2020","journal-title":"Spine"},{"key":"B3","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1007\/s00590-018-2291-y","article-title":"Sprengel's deformity of the shoulder joint treated by woodward operation","volume":"29","author":"Elzohairy","year":"2019","journal-title":"Eur J Orthop Surg Traumatol"},{"key":"B4","doi-asserted-by":"crossref","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":"B5","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1007\/s43465-020-00187-3","article-title":"A novel modification of woodward procedure for correction of Sprengel deformity by application of anchoring sutures","volume":"55","author":"Alsiddiky","year":"2020","journal-title":"Indian J Orthop"},{"key":"B6","doi-asserted-by":"publisher","first-page":"986","DOI":"10.1302\/0301-620x.87b7.16148","article-title":"Osteotomy for congenital elevation of the scapula (Sprengel's deformity)","volume":"87","author":"McMurtry","year":"2005","journal-title":"J Bone Joint Surg Br"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1199","DOI":"10.2106\/00004623-198163080-00001","article-title":"Congenital elevation of the scapula. 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